Hypotensive resuscitation for traumatic hemorrhagic shock: a systematic review
10.3760/cma.j.issn.1671-0282.2016.05.013
- VernacularTitle:低压复苏治疗创伤失血性休克的系统评价
- Author:
Zhusheng FENG
;
Yingnan FAN
;
Junjie LI
;
Qianmei WANG
;
Wen YIN
- Publication Type:Journal Article
- Keywords:
Hypotensive resuscitation;
Trauma;
Shock;
Systematic review;
GRADE system
- From:Chinese Journal of Emergency Medicine
2016;25(5):605-609
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically review the efficacy of hypotensive resuscitation for traumatic-hemorrhagic shock.Methods Randomized controlled trails (RCTs) or quasi-Randomized controlled trails (qRCTs) were searched in Pubmed,Embase and the Corchrane Library from inception to August 2015.Two reviewers respectively picked out the useful data and performed quality evaluation.Metaanalysis was carried out with RevMan 5.3 software,risk ratio (RR) and its 95％ confidence interval (CI) were pooled to estimate the enumeration data,and GRADE 3.6.1 software was used to rate the level of evidence.Results The results of meta-analysis and GRADE rating system which included 4 studies showed that:compared with conventional resuscitation,hypotensive resuscitation was associated with lower total mortality [RR =0.77,95％ CI:0.62-0.95,P =0.01;n =984,GRADE rating:moderate],and 24-hour mortality [RR =0.47,95％ CI:0.24-0.91,P =0.03;n =281,GRADE rating:moderate],but the subgroup analysis of total mortality showed that there were no significant differences in mortality between the subgroup of blunt or penetrating trauma and the subgroup of penetrating trauma.Conclusions Hypotensive resuscitation reduced total mortality and 24-hour mortality,and the quality of the evidence was moderate.The future studies should do further research to explore the efficacy of hypotensive resuscitation for different types of trauma.
