Cargando…

Optimal target blood pressure in critically ill adult patients with vasodilatory shock: a protocol for a systematic review and meta-analysis

INTRODUCTION: The optimal target of mean arterial pressure (MAP) for better outcomes in patients with vasodilatory shock remains a matter of debate. Although catecholamines are generally used to maintain target blood pressure in hypotensive patients with vasodilatory shock, the adverse effects of ca...

Descripción completa

Detalles Bibliográficos
Autores principales: Fukui, Satoshi, Higashio, Koki, Murao, Shuhei, Endo, Akira, Akira, Takasu, Yamakawa, Kazuma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7986773/
https://www.ncbi.nlm.nih.gov/pubmed/33741676
http://dx.doi.org/10.1136/bmjopen-2020-048512
_version_ 1783668509403774976
author Fukui, Satoshi
Higashio, Koki
Murao, Shuhei
Endo, Akira
Akira, Takasu
Yamakawa, Kazuma
author_facet Fukui, Satoshi
Higashio, Koki
Murao, Shuhei
Endo, Akira
Akira, Takasu
Yamakawa, Kazuma
author_sort Fukui, Satoshi
collection PubMed
description INTRODUCTION: The optimal target of mean arterial pressure (MAP) for better outcomes in patients with vasodilatory shock remains a matter of debate. Although catecholamines are generally used to maintain target blood pressure in hypotensive patients with vasodilatory shock, the adverse effects of catecholamines must also be considered. We will perform a systematic review and meta-analysis of randomised controlled trials (RCTs) to assess the certainty of evidence determining the optimal target of MAP control for patients with vasodilatory shock in critically ill settings. METHODS AND ANALYSIS: This study protocol was registered in the University Hospital Medical Information Network Clinical Trials Registry. We will include only RCTs that evaluated the two different comparators for target MAP to be maintained for clinical outcomes of all-cause mortality: organ dysfunction and adverse events in critically ill adult patients with vasodilatory shock. We will search the electronic bibliographic databases of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials in November 2020. Two reviewers will independently screen titles and abstracts, perform full article reviews and extract study data. We will report study characteristics and assess methodological quality using the Cochrane Risk-of-Bias 2 tool. If pooling is appropriate, we will calculate relative risks with 95% CIs for all outcome measures. Clinical and methodological subgroup and sensitivity analyses will be performed to explore heterogeneity. Overall certainty of evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION: This study will not involve primary data collection, and formal ethics approval will therefore not be required. We aim to publish this systematic review in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: UMIN000042624.
format Online
Article
Text
id pubmed-7986773
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-79867732021-03-29 Optimal target blood pressure in critically ill adult patients with vasodilatory shock: a protocol for a systematic review and meta-analysis Fukui, Satoshi Higashio, Koki Murao, Shuhei Endo, Akira Akira, Takasu Yamakawa, Kazuma BMJ Open Intensive Care INTRODUCTION: The optimal target of mean arterial pressure (MAP) for better outcomes in patients with vasodilatory shock remains a matter of debate. Although catecholamines are generally used to maintain target blood pressure in hypotensive patients with vasodilatory shock, the adverse effects of catecholamines must also be considered. We will perform a systematic review and meta-analysis of randomised controlled trials (RCTs) to assess the certainty of evidence determining the optimal target of MAP control for patients with vasodilatory shock in critically ill settings. METHODS AND ANALYSIS: This study protocol was registered in the University Hospital Medical Information Network Clinical Trials Registry. We will include only RCTs that evaluated the two different comparators for target MAP to be maintained for clinical outcomes of all-cause mortality: organ dysfunction and adverse events in critically ill adult patients with vasodilatory shock. We will search the electronic bibliographic databases of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials in November 2020. Two reviewers will independently screen titles and abstracts, perform full article reviews and extract study data. We will report study characteristics and assess methodological quality using the Cochrane Risk-of-Bias 2 tool. If pooling is appropriate, we will calculate relative risks with 95% CIs for all outcome measures. Clinical and methodological subgroup and sensitivity analyses will be performed to explore heterogeneity. Overall certainty of evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION: This study will not involve primary data collection, and formal ethics approval will therefore not be required. We aim to publish this systematic review in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: UMIN000042624. BMJ Publishing Group 2021-03-19 /pmc/articles/PMC7986773/ /pubmed/33741676 http://dx.doi.org/10.1136/bmjopen-2020-048512 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Intensive Care
Fukui, Satoshi
Higashio, Koki
Murao, Shuhei
Endo, Akira
Akira, Takasu
Yamakawa, Kazuma
Optimal target blood pressure in critically ill adult patients with vasodilatory shock: a protocol for a systematic review and meta-analysis
title Optimal target blood pressure in critically ill adult patients with vasodilatory shock: a protocol for a systematic review and meta-analysis
title_full Optimal target blood pressure in critically ill adult patients with vasodilatory shock: a protocol for a systematic review and meta-analysis
title_fullStr Optimal target blood pressure in critically ill adult patients with vasodilatory shock: a protocol for a systematic review and meta-analysis
title_full_unstemmed Optimal target blood pressure in critically ill adult patients with vasodilatory shock: a protocol for a systematic review and meta-analysis
title_short Optimal target blood pressure in critically ill adult patients with vasodilatory shock: a protocol for a systematic review and meta-analysis
title_sort optimal target blood pressure in critically ill adult patients with vasodilatory shock: a protocol for a systematic review and meta-analysis
topic Intensive Care
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7986773/
https://www.ncbi.nlm.nih.gov/pubmed/33741676
http://dx.doi.org/10.1136/bmjopen-2020-048512
work_keys_str_mv AT fukuisatoshi optimaltargetbloodpressureincriticallyilladultpatientswithvasodilatoryshockaprotocolforasystematicreviewandmetaanalysis
AT higashiokoki optimaltargetbloodpressureincriticallyilladultpatientswithvasodilatoryshockaprotocolforasystematicreviewandmetaanalysis
AT muraoshuhei optimaltargetbloodpressureincriticallyilladultpatientswithvasodilatoryshockaprotocolforasystematicreviewandmetaanalysis
AT endoakira optimaltargetbloodpressureincriticallyilladultpatientswithvasodilatoryshockaprotocolforasystematicreviewandmetaanalysis
AT akiratakasu optimaltargetbloodpressureincriticallyilladultpatientswithvasodilatoryshockaprotocolforasystematicreviewandmetaanalysis
AT yamakawakazuma optimaltargetbloodpressureincriticallyilladultpatientswithvasodilatoryshockaprotocolforasystematicreviewandmetaanalysis