TY - JOUR
T1 - A Systematic Review and International Web-Based Survey of Randomized Controlled Trials in the Perioperative and Critical Care Setting
T2 - Interventions Reducing Mortality
AU - Sartini, Chiara
AU - Lomivorotov, Vladimir
AU - Pieri, Marina
AU - Lopez-Delgado, Juan Carlos
AU - Baiardo Redaelli, Martina
AU - Hajjar, Ludhmila
AU - Pisano, Antonio
AU - Likhvantsev, Valery
AU - Fominskiy, Evgeny
AU - Bradic, Nikola
AU - Cabrini, Luca
AU - Novikov, Maxim
AU - Avancini, Daniele
AU - Riha, Hynek
AU - Lembo, Rosalba
AU - Gazivoda, Gordana
AU - Paternoster, Gianluca
AU - Wang, Chengbin
AU - Tamà, Simona
AU - Alvaro, Gabriele
AU - Wang, Chew Yin
AU - Roasio, Agostino
AU - Ruggeri, Laura
AU - Yong, Chow Yen
AU - Pasero, Daniela
AU - Severi, Luca
AU - Pasin, Laura
AU - Mancino, Giuseppe
AU - Mura, Paolo
AU - Musu, Mario
AU - Spadaro, Savino
AU - Conte, Massimiliano
AU - Lobreglio, Rosetta
AU - Silvetti, Simona
AU - Votta, Carmine Domenico
AU - Belletti, Alessandro
AU - Di Fraja, Diana
AU - Corradi, Francesco
AU - Brusasco, Claudia
AU - Saporito, Emanuela
AU - D'Amico, Alessandro
AU - Sardo, Salvatore
AU - Ortalda, Alessandro
AU - Riefolo, Claudio
AU - Monaco, Fabrizio
AU - Zangrillo, Alberto
AU - Bellomo, Rinaldo
AU - Landoni, Giovanni
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - The authors aimed to identify interventions documented by randomized controlled trials (RCTs) that reduce mortality in adult critically ill and perioperative patients, followed by a survey of clinicians’ opinions and routine practices to understand the clinicians’ response to such evidence. The authors performed a comprehensive literature review to identify all topics reported to reduce mortality in perioperative and critical care settings according to at least 2 RCTs or to a multicenter RCT or to a single-center RCT plus guidelines. The authors generated position statements that were voted on online by physicians worldwide for agreement, use, and willingness to include in international guidelines. From 262 RCT manuscripts reporting mortality differences in the perioperative and critically ill settings, the authors selected 27 drugs, techniques, and strategies (66 RCTs, most frequently published by the New England Journal of Medicine [13 papers], Lancet [7], and Journal of the American Medical Association [5]) with an agreement ≥67% from over 250 physicians (46 countries). Noninvasive ventilation was the intervention supported by the largest number of RCTs (n = 13). The concordance between agreement and use (a positive answer both to “do you agree” and “do you use”) showed differences between Western and other countries and between anesthesiologists and intensive care unit physicians. The authors identified 27 clinical interventions with randomized evidence of survival benefit and strong clinician support in support of their potential life-saving properties in perioperative and critically ill patients with noninvasive ventilation having the highest level of support. However, clinician views appear affected by specialty and geographical location.
AB - The authors aimed to identify interventions documented by randomized controlled trials (RCTs) that reduce mortality in adult critically ill and perioperative patients, followed by a survey of clinicians’ opinions and routine practices to understand the clinicians’ response to such evidence. The authors performed a comprehensive literature review to identify all topics reported to reduce mortality in perioperative and critical care settings according to at least 2 RCTs or to a multicenter RCT or to a single-center RCT plus guidelines. The authors generated position statements that were voted on online by physicians worldwide for agreement, use, and willingness to include in international guidelines. From 262 RCT manuscripts reporting mortality differences in the perioperative and critically ill settings, the authors selected 27 drugs, techniques, and strategies (66 RCTs, most frequently published by the New England Journal of Medicine [13 papers], Lancet [7], and Journal of the American Medical Association [5]) with an agreement ≥67% from over 250 physicians (46 countries). Noninvasive ventilation was the intervention supported by the largest number of RCTs (n = 13). The concordance between agreement and use (a positive answer both to “do you agree” and “do you use”) showed differences between Western and other countries and between anesthesiologists and intensive care unit physicians. The authors identified 27 clinical interventions with randomized evidence of survival benefit and strong clinician support in support of their potential life-saving properties in perioperative and critically ill patients with noninvasive ventilation having the highest level of support. However, clinician views appear affected by specialty and geographical location.
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U2 - 10.1053/j.jvca.2018.11.026
DO - 10.1053/j.jvca.2018.11.026
M3 - Article
C2 - 30600204
AN - SCOPUS:85059136492
SN - 1053-0770
VL - 33
SP - 1430
EP - 1439
JO - Journal of cardiothoracic and vascular anesthesia
JF - Journal of cardiothoracic and vascular anesthesia
IS - 5
ER -