Background: Early mobilization (EM) is a regimen that was carried out by physiotherapists in a relatively early stage. It has been investigated by an increasing number of researchers. However, there has not been a meta-analysis concerning whether EM could benefit the clinical outcomes of critically ill patients requiring mechanical ventilation (MV). The present systematic review aims to evaluate the effect of EM compared with immobilization for mechanically ventilated patients. Methods: A computerized literature search was performed in six databases for related articles from inception to June 2017. We included randomized controlled trials and controlled clinical trials and used the Physiotherapy Evidence Database scale to assess the quality of included studies. Primary outcomes were measures of muscle function, duration of MV, and incidence of mortality. Secondary outcomes were adverse effects and length of stay (LOS) in intensive care unit (ICU) and hospital. Results: Eight trials were included; of those, only one study without standard EM reported that the intervention was invalid to improve the outcomes. The result of meta-analysis indicated that EM shortened the duration of MV; however, it had no positive effect on mortality and LOS in ICU. Conclusions: This review suggests that EM improves the muscle function and ventilation duration. Further research highlighting standard intervention and specific groups is needed.
AimTo evaluate the clinical application of moist wound dressings in wound care for patients with the tracheostomy.BackgroundTracheostomy patients may suffer from many complications. Moist dressings have been proposed to lower complication rates for patients with the tracheostomy.DesignA Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) checklist‐guided meta‐analysis of randomised and controlled clinical trials.MethodIn this meta‐analysis, two reviewers independently searched PubMed, EMBASE, Cochrane Library, Web of Science, CNKI and Wanfang databases for controlled clinical trials (CCTs) comparing the use of moist dressings and gauze for tracheostomy patients. The reviewers screened studies according to the inclusion criteria and extracted data from published reports independently. The outcome of site infection and pressure ulcer incidence, the frequency of dressing changes and wound closing time were evaluated by random‐effects or fixed‐effects meta‐analysis.ResultsAfter the screening, ten studies including 1,220 participants were eligible for analysis. The result showed that the incidence of site infection and pressure ulcer was significantly reduced in the moist dressings group compared with the gauze group. Moist dressings were also associated with significant reductions in the frequency of dressing changes and wound closing time. These results were assessed as moderate‐ to low‐quality evidence.ConclusionMoist dressings seem to be beneficial to tracheostomy patients, giving a lower incidence of site infection and pressure ulcers as well as shorter wound closing times and lower dressing change frequency. More high‐quality trials are needed to support this finding.Relevance to clinical practiceThe findings offer clinicians an assessment of and evidence for the efficacy of moist dressings, which may be a superior option for patients with a tracheotomy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.