Home > Search Results

Results: 1 to 20 of 22

Non‐invasive positive pressure ventilation for cardiogenic pulmonary oedema

Acute heart failure has a high incidence in the general population and may lead to  the accumulation of fluid in the lungs, which is called acute cardiogenic pulmonary oedema (ACPE). This review aimed to determine the effectiveness and safety of non‐invasive positive pressure ventilation (NPPV) (continuous positive airway pressure (CPAP) or bilevel NPPV) plus standard medical care, compared with standard medical care alone in adults with ACPE. We included 32 studies (2916 participants) of generally low or uncertain risk of bias. Results from randomised controlled trials indicate that NPPV can significantly reduce mortality as well as the need for endotracheal intubation rate, the number of days spent in the intensive care unit without increasing the risk of having a heart attack during or after treatment. We identified fewer adverse events with NPPV use (in particular progressive respiratory distress and neurological failure [coma]) when compared with standard medical care. In our comparison of CPAP and bilevel NPPV, CPAP may be considered the first option in selection of NPPV due to more robust evidence for its effectiveness and safety and lower cost compared with bilevel NPPV. The evidence to date on the potential benefit of NPPV in reducing mortality is entirely derived from small‐trials and further large‐scale trials are needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Pulmonary artery catheters for directing management in condition associated with high blood pressure during pregnancy

Pre‐eclampsia (a condition associated with high blood pressure during pregnancy) or toxaemia affects a significant number of pregnancies and is a major cause of serious illness and even death of mothers and babies during pregnancy and shortly after. Pre‐eclampsia can cause decreased blood flow to the kidneys resulting in kidney failure and fluid accumulation in the lungs and other organs. Managing fluid shifts is, thus, crucial to preventing and managing such complications. The pulmonary artery catheter is one method of monitoring fluid status. The pulmonary artery catheter is a special device placed inside of the pulmonary artery for  measurement of pressures in the different parts of heart, which helps to monitor the fluid balance in the body. Although it seem to be the most reliable method for monitoring of fluid shifts, the placement of pulmonary artery catheters may be associated with the highest risk of complications. No randomised trials involving pulmonary artery catheterisation were found and, thus, there is no robust data to support or disregard the use of this intervention. The complexity of this procedure and the skills needed to perform it may have affected the lack of randomised trials. Nevertheless, fluid management is still an important issue in managing and preventing kidney failure and accumulation of fluid in the lungs and other organs in the context of pre‐eclampsia and pulmonary artery catheterisation is a potential technique for this. We think that further research, especially randomised trials, is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Causes and signs of edema

Edema (or "oedema") means swelling. The condition called edema arises when part of the body becomes swollen because fluid builds up in the tissue. It most commonly affects the arms and legs. That is called peripheral edema.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: December 30, 2016

Compression stockings for preventing deep vein thrombosis (DVT) in airline passengers

In the last few years, there has been increasing interest in whether compression stockings (or 'flight socks') reduce the risk of deep vein thrombosis (DVT; blood clots in the legs) and other circulatory problems in airline passengers. The stockings are worn throughout the flight and are similar to those known to be effective in patients lying in bed after an operation. By applying a gentle pressure, to the ankle in particular, compression stockings help blood to flow. Pressure combined with leg movement helps blood in superficial (surface) veins to move to the deep veins and back to the heart. The blood is then less likely to clot in the deep veins, which could be fatal if the clot moves to the lungs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Drugs assessed by IQWiG: Overview

Since early 2011, the added benefit of most medications containing new active ingredients must be assessed as soon as they enter the market in Germany. The most important results of the IQWiG reviews are summarized here.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 6, 2017

Heart failure: Overview

Lots of people with heart failure avoid physical exercise to prevent breathlessness and heavy breathing. But exercise has been shown to be good for heart failure in the long term: Studies show that special cardio training programs can imrpove fitness and quality of life.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: August 27, 2014

Digoxin for preventing or treating neonatal respiratory distress syndrome

There is no evidence that the administration of digoxin helps babies with neonatal respiratory distress syndrome.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Corticosteroids for HELLP syndrome in pregnancy

Pre‐eclampsia is a serious complication of pregnancy characterized by high blood pressure with protein in the urine and sometimes progression to seizures (fits). HELLP syndrome is a more severe form of pre‐eclampsia which can cause problems with liver function, blood clotting, and low platelets. HELLP may be diagnosed during pregnancy or after giving birth and is associated with ill health for the mother including liver hematoma, rupture, or failure; pulmonary edema; renal failure and death. Infant health may also be poor, primarily due to premature birth and growth restriction.This review examined the effect of treating women with HELLP syndrome using corticosteroids (which can reduce inflammation). The results of this review did not indicate that there was a clear effect on the health of pregnant women when treated with corticosteroids, or their babies. Corticosteroids did appear to improve some components of the women's blood tests, but it is not clear that this had an effect on their overall health. The review identified 11 randomized controlled trials involving 550 women that compared corticosteroid (dexamethasone, betamethasone, or prednisolone) given during pregnancy, just after delivery or in the postnatal period, or both before and after birth, with placebo or no treatment. Two further trials showed that there was no clear difference between dexamethasone and betamethasone on the substantive clinical outcomes for women or their infants. Dexamethasone did improve maternal platelet count and some biochemical measures to a greater extent than betamethasone.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Sargramostim (GM‐CSF) for induction of remission in Crohn's disease

Crohn's disease is a chronic inflammatory condition of the gut. New theories regarding the cause of this inflammation has led some investigators to think it is a weak immune system, rather than an overactive one, that leads to this condition. They tested this idea using a drug called sargramostim, which boosts the immune system, in patients with Crohn's disease. This review of three studies did not show any difference in effectiveness between sargramostim and placebo (fake drug) for induction of remission or clinical improvement in patients with active Crohn's disease. Side effects associated with sargramostim treatment included bone pain, musculoskeletal chest pain, and dyspnea (shortness of breath). Due to the fact that there were only a small number of trials in this area and some of them give opposite results, the authors concluded that while sargramostim does not appear to be more effective than placebo more research is needed to determine if this drug provides a benefit for the treatment of active Crohn's disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Subintimal angioplasty for lower limb arterial chronic total obstructions

The most common symptom of arterial disease of the leg is claudication, a cramping pain caused by an inadequate supply of blood to the affected muscle. Claudication often affects the calf muscle and is typically triggered by exercise and relieved by rest. More severe restriction of the blood supply may result in pain at rest, leg ulcers, or gangrene. Arterial disease, and particularly severe claudication, may require bypass surgery or angioplasty (surgical procedure to widen narrowed or obstructed arteries or veins) to improve blood flow to the leg. However, in long arterial occlusions (obstructions) with hard plaque, normal transluminal angioplasty often fails. Subintimal angioplasty for peripheral vascular disease was first described in the 1990s. The subintimal space at the start of the occlusion is entered with a wire loop that is used to cross the occlusion with the support of catheter and re‐enter the vessel lumen of the patent (not‐obstructed) distal artery to form a new blood flow channel. This technology has enabled the development of devices such as the OUTBACK re‐entry catheter.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Fluids for people with stroke

Fluids given into a vein (intravenous, or iv) or under the skin (subcutaneous) are commonly used in people with stroke, but there are no clear guidelines on the best fluid management in such cases. There are a number of possible different types of fluid that can be used: isotonic fluids, or crystalloids are solutions that contain similar amounts of dissolved salts as in normal cells and blood, whilst hypertonic fluids, or colloids usually contain more (or larger) dissolved particles than in normal cells and blood. Fluid can also be given in different volumes, or for different durations. Hence, we searched the available literature to find answers to these questions.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Loop diuretics for patients receiving blood transfusions

Blood transfusions are often complicated by water retention, which may worsen lung function, heart function and/or kidney function. Loop diuretics, medications that reduce body water by making the kidneys excrete more urine, are thought to prevent water retention. Accordingly, many doctors pre‐medicate their blood transfusion recipients with loop diuretics.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Different magnesium sulphate regimens given to mothers to prevent preterm labour

Babies born early ‐ before 37 weeks' estimated gestation ‐ are at an increased risk of dying or being seriously unwell, especially if they are born very early. Various drugs have been given to women to try and stop babies being born too soon. Magnesium sulphate has been one of the drugs used when women go into labour too early.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Perioperative increase in global blood flow to explicit defined goals and outcomes following surgery

Death and serious complications commonly occur following major surgery and are a significant public health problem. These outcomes might be prevented by using fluids and drugs to maintain the supply of oxygen and other nutrients to vital organs. Global blood flow, adjusted to maintain specific targets, might serve as a proxy in determining whether administered fluid and drugs maintain critical nutrient supply. In this Cochrane review of 31 studies conducted in 5292 patients undergoing major surgery, the use of fluids, with or without additional drugs, to achieve defined targets associated with increased total blood flow did not reduce mortality. There was a reduction in the number of patients with complications and the length of time patients stayed in hospital (by 1.2 days). However, the quality of the studies in this area was mediocre.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Surgical versus non‐surgical treatment for lumbar spinal stenosis

Review question: We reviewed the evidence that compares surgery versus non‐surgical treatment for a condition called lumbar spinal stenosis. This condition occurs when the area surrounding the spinal cord and nerves becomes smaller.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Aerosolized diuretics for preterm infants with (or developing) chronic lung disease

There is no evidence of benefit from routine use of inhaled diuretics in preterm babies at risk of chronic lung disease. Lung disease in babies born early (preterm) is often complicated with excess accumulation of water in the lungs. Medications that reduce body water (diuretics) might help the baby recover from lung disease. In theory, giving the diuretic as an inhaled mist (aerosol) could drain water from the lung more than from the rest of the body, which could reduce adverse effects. The review found several small trials of a single type of diuretic (furosemide). A single dose improved lung function, but only temporarily. No information was available about long term outcome.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Diuretics acting on the distal renal tubule for preterm infants with (or developing) chronic lung disease

There is no strong evidence of benefit from routine use of distal diuretics in preterm infants with chronic lung disease. Lung disease in infants born early (preterm) is often complicated with excess of water. Medications that reduce body water (diuretics) might help the infant recover from lung disease. The review of trials analysed the effects of diuretics working on the end of the small kidney tubes (distal diuretics). It found that diuretic treatment for four weeks improved lung function. Only one study showed long term benefit (decreased rates of death and artificial ventilation). However, the infants in these trials did not receive all the medications that are currently available.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Diuretics for respiratory distress syndrome in preterm infants

There is not enough data to support the routine use of diuretics for respiratory distress syndrome in newborn babies. Diuretics are drugs that increase the production of urine by encouraging salt and water to be released from the kidneys. When newborn babies have respiratory distress syndrome (RDS), their lungs may also contain excess fluid that can cause breathing problems. Babies with RDS sometimes may also have a reduced urine output. Using diuretics in these babies may improve lung or kidney function transiently, but may also increase cardiovascular complications. The review of trials did not find enough evidence supporting the routine use of diuretics in these infants.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Early emergency department treatment of acute asthma with systemic corticosteroids

In an asthma attack, the airways (passages to the lungs) narrow from muscle spasms and swelling (inflammation). Bronchodilators (reliever inhalers to open up the lungs and airways) can be used for the spasms, and corticosteroids for the swelling. Corticosteroids can be inhaled, or taken by mouth (orally) or through a drip into the veins (intravenously). The review of trials found that systemic (oral or intravenous) corticosteroids reduce the need for people with asthma attacks to stay in hospital, with few adverse effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Interventions for preventing venous thromboembolism in adults undergoing knee arthroscopy

Knee arthroscopy is a common, minimally invasive surgical procedure used both for diagnosis and treatment of knee conditions. It is increasingly carried out in day surgery using various types of anaesthesia. Some people are at increased risk of developing deep vein thrombosis (DVT) because of factors including a previous history, immobilization, smoking, obesity, varicose veins and increasing age. Different approaches are available for preventing DVT (thromboprophylaxis), both mechanically and with drug medication. The characteristic symptoms of DVT are limb pain and swelling (edema) but often there are no obvious signs or symptoms. DVT at or above knee level (proximal) is associated with an increased risk of pulmonary embolism (which can be fatal) but isolated calf DVT (distal) rarely causes symptoms and is asymptomatic. Arthroscopy patients are often young and soon become mobile again. The incidence of DVT is reported to be from 0.6% when diagnosed clinically to 17.9% using the most sensitive imaging techniques (venography).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Systematic Reviews in PubMed

See all (300)...

Systematic Review Methods in PubMed

See all (2)...

Recent Activity

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...