METHODS: We searched Medline and Scopus, following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement; we searched for retrospective and prospective observational studies, interventional studies, and randomized clinical trials that performed a hyperoxia challenge in patients with acute brain injury who were concomitantly monitored with cerebral microdialysis. This study was registered in PROSPERO (CRD420211295223).
RESULTS: We included a total of 17 studies, with a total of 311 patients. A statistically significant reduction in cerebral lactate values (pooled standardized mean difference [SMD] - 0.38 [- 0.53 to - 0.23]) and lactate to pyruvate ratio values (pooled SMD - 0.20 [- 0.35 to - 0.05]) was observed after hyperoxia. However, glucose levels (pooled SMD - 0.08 [- 0.23 to 0.08]) remained unchanged after hyperoxia.
CONCLUSIONS: Normobaric hyperoxia may improve cerebral metabolic disturbances in patients with acute brain injury. The clinical impact of such effects needs to be further elucidated.
方法:我们搜索了Medline和Scopus,遵循系统评价和荟萃分析声明的首选报告项目的建议;我们搜索了回顾性和前瞻性观察性研究,介入研究,和随机临床试验,对同时监测脑微透析的急性脑损伤患者进行高氧攻击。本研究在PROSPERO(CRD420211295223)注册。
结果:我们共纳入了17项研究,共有311名患者。高氧后观察到大脑乳酸值(合并的标准化平均差[SMD]-0.38[-0.53至-0.23])和乳酸与丙酮酸比率值(合并的SMD-0.20[-0.35至-0.05])的统计学显着降低。然而,高氧后,葡萄糖水平(合并SMD-0.08[-0.23至0.08])保持不变。
结论:常压高氧可改善急性脑损伤患者的脑代谢紊乱。这种效应的临床影响需要进一步阐明。