Cochrane Summaries 2023-2024
The use of balanced solution appears to be of slight benefit in children with severe dehydration following acute diarrhea
SOURCE
Florez ID, Sierra J, Pérez-Gaxiola G.
Balanced crystalloid solutions versus 0.9% saline for treating acute diarrhea and severe dehydration in children.
Cochrane Database of Systematic Reviews 2023, Issue 5. Art. No.: CD013640. DOI:10.1002/14651858.CD013640.pub2
CONTEXT
In the event of acute diarrhea and severe dehydration in children, management may require the administration of intravenous fluids. The most commonly used solution is 0.9% isotonic saline solution (ISS). Balanced solutions, recommended in the management of sepsis, have a composition closer to human plasma and limit the risk of hyperchloremic acidosis.
During vaso-occlusive crises in sickle cell patients, the efficacy of nitric oxide remains to be demonstrated
SOURCE
Aboursheid T, Albaroudi O, Alahdab F.
Inhaled nitric oxide for treating pain crises in people with sickle cell disease. CochraneDatabase of Systematic Reviews 2022, Issue 7. Art. No.: CD011808.
DOI: 10.1002/14651858.CD011808.pub3
CONTEXT
In sickle cell disease patients, vaso-occlusive crises can cause severe pain lasting from several hours to several days. The vasodilatory properties of inhaled nitric oxide (NO) could have a beneficial effect in this indication, but its actual efficacy remains debated.
Magnesium sulphate in acute exacerbations of chronic obstructive pulmonary disease: benefit not yet fully demonstrated
SOURCE
Ni H, Aye SZ, Naing C.
Magnesium sulfate for acute exacerbations of chronic obstructive pulmonary disease.
Cochrane Database of Systematic Reviews 2022, Issue 5. Art. No.: CD013506.
DOI: 10.1002/14651858.CD013506.pub2
CLINICAL QUESTION
What are the effects of intravenous (IV) or inhaled magnesium sulphate (MgSO4) in adult patients with chronic obstructive pulmonary disease (COPD) exacerbations?
The more difficult the patient is to perfuse, the more useful is ultrasound-guided peripheral intravenous cannulation
SOURCE
Tada M, Yamada N, Matsumoto T, Takeda C, Furukawa TA, Watanabe N.
Ultrasound guidance versus landmark method for peripheral venous cannulation in adults.
Cochrane Database of Systematic Reviews 2022, Issue 12. Art. No.: CD013434.
DOI:10.1002/14651858.CD013434.pub2.
CONTEXT
Peripheral intravenous cannulation (PIC) is a common and important procedure for patients requiring a blood test or intravenous (IV) therapies. The landmark method, which relies on touch and visualization of veins on the skin, can be complex and may result in treatment delays, multiple painful punctures, and the need for intraosseous or central lines. The effectiveness of ultrasound guidance for PIC is still unclear.
Videolaryngoscopy may reduce the number of intubations attempts in neonates
SOURCE
Lingappan K, Neveln N, Arnold JL, Fernandes CJ, Pammi M.
Videolaryngoscopy versus direct laryngoscopy for tracheal intubation in neonates.
Cochrane Database of Systematic Reviews 2023, Issue 5. Art. No.: CD009975.
DOI: 10.1002/14651858.CD009975.pub4.
CONTEXT
Rapid establishment of a secure airway is key in neonatal resuscitation. Videolaryngoscopy is emerging
as a new technique for intubation, and it may accelerate successful endotracheal intubation when
compared to direct laryngoscopy in neonates.
Orotracheal intubation success in adults is greater with videolaryngoscopy than direct laryngoscopy
SOURCE
Hansel J, Rogers AM, Lewis SR, Cook TM, Smith AF.
Videolaryngoscopy versus direct laryngoscopy for adults undergoing tracheal intubation.
Cochrane Database of Systematic Reviews 2022, Issue 4. Art. No.: CD011136.
DOI: 10.1002/14651858.CD011136.pub3.
CONTEXT
Tracheal intubation is a common procedure in operating theatres, emergency departments,
outpatient departments and critical care units. In around 10% of cases, intubation is difficult and
associated with a risk of complications: hypoxemia, inhalation pneumonitis, rhythm disorders,
cardiac arrest and death.
Benefits of continuous positive airway pressure (CPAP) for acute bronchiolitis
SOURCE
Jat KR, Dsouza JM, Mathew JL. Continuous positive airway pressure (CPAP) for acute bronchiolitis in children. Cochrane Database of Systematic Reviews 2022, Issue 4. Art. No.: CD010473. DOI: 10.1002/14651858.CD010473.pub4
BACKGROUND
Bronchiolitis is a common cause for pediatric emergency visits and hospitalization. There is no specific treatment for bronchiolitis, yet continuous positive airway pressure (CPAP) has been used to prevent the need for mechanical ventilation.
Favorable benefit-risk balance for oral antiplatelet agents in acute ischaemic stroke
BACKGROUND
Strokes constitute a major public health problem worldwide (15 million cases/year) and are mostly ischaemic. Oral antiplatelet agents aim to reduce the risk of cerebral ischemia by inhibiting platelet adhesion and aggregation. However, antiplatelet agents could also increase the risk of fatal or disabling intracranial haemorrhage.
Chest imaging in the diagnosis of COVID-19: fairly sensitive, but insufficiently specific!
Islam_N, Ebrahimzadeh_S, Salameh_J-P, Kazi_S, Fabiano_N, Treanor L et al (2022)
Thoracic imaging tests for the diagnosis of COVID-19.
Cochrane Database Syst Rev, 5, CD013639.
CONTEXT
COVID-19 presents a diagnostic challenge with reverse transcription polymerase chain reaction (RT-PCR) tests having limitations. The potential contribution of additional thoracic imaging is unclear...
Benefit of low-dose colchicine for acute gout
McKenzie BJ, Wechalekar MD, Johnston RV, Schlesinger N, Buchbinder R. (2021)
Colchicine for acute gout
Cochrane Database Syst Rev, 8, CD006190.
CONTEXT
Gout is one of the most common rheumatic diseases worldwide. Colchicine is the first-line treatment but evidence on its dosage, benefits and harms is limited...
Intravenous thrombolysis and endovascular thrombectomy are effective in treating some ischaemic strokes of awakening
SOURCE
Roaldsen MB, Lindekleiv H, Mathiesen EB. (2021)
Intravenous thrombolytic treatment and endovascular thrombectomy for ischaemic wake-up stroke.
Cochrane Database Syst Rev 12:CD010995
CONTEXT
About one in 5 strokes occurs during sleep. Stroke of awakening has long been excluded from emergency care for lack of information on the time between the onset of stroke and awakening. Some waking strokes, via rigorous selection based on imaging criteria,seem to benefit from aggressive management with improved outcomes in some patients ...
No short- or long-term net benefit of early anticoagulant therapy
SOURCE
Wang X, Ouyang M, Yang J, Song L, Yang M, Anderson CS. (2021)
Anticoagulants for acute ischaemic stroke.
Cochrane Database Syst Rev 10:CD000024
CONTEXT
Stroke is the third leading cause of premature death worldwide. Most strokes are ischaemic. The use of anticoagulants could be proposed to improve patient outcomes and limit recurrence without increasing the risk of bleeding events ...
