背景:在神经重症监护病房中经常使用氧气。避免低氧血症是急性脑损伤(ABI)患者的关键目标。然而,多项研究表明,在这些患者中,高氧血症也可能与较高的死亡率和较差的神经系统预后有关.由于前瞻性研究的数量有限,这方面的证据仍然存在争议,缺乏对高氧血症的共同定义,实验设计的异质性和ABI的不同原因。探讨高氧血症与住院成人ABI患者神经功能转归和死亡率的相关性。我们将对观察性研究和随机对照试验进行系统评价和荟萃分析.
方法:系统评价方法已根据系统评价和荟萃分析(PRISMA)指南的首选报告项目定义,并遵循PRISMA方案结构。直到2024年6月发表的研究将在电子数据库MEDLINE中确定,Embase,Scopus,WebofScience,科克伦图书馆,护理和相关健康文献和临床试验的累积指数。检索到的记录将由四名成对工作的作者独立筛选,选择的变量将从报告关于“高氧血症”和“无高氧血症”对住院ABI患者的神经系统结局和死亡率的影响的研究中提取。我们将在报告时使用协变量调整的OR作为结果测量,因为它们考虑了潜在的共同创始人,并提供了对高氧血症和结果之间关联的更准确的估计;当不可用时,我们将使用单变量OR。如果研究将结果显示为相对风险,只要该疾病的患病率接近10%,它将被认为等同于OR。将应用随机效应荟萃分析计算两种结果的汇总估计。研究间的异质性将使用I2统计量进行评估;偏倚风险将通过非随机干预研究中的偏倚风险进行评估。纽卡斯尔-渥太华或RoB2工具。根据数据可用性,我们计划按ABI类型进行亚组分析(创伤性脑损伤,心脏骤停后,蛛网膜下腔出血,脑出血和缺血性中风),动脉氧分压值,学习质量,学习时间,神经学评分和其他选定的感兴趣的临床变量。
背景:不需要特定的伦理批准同意,因为这是对先前发布的匿名数据的审查。研究结果将通过在同行评审的期刊上发表并在相关会议和研讨会上发表与科学界分享。它还将是共同的关键利益相关者,如国家或国际卫生当局,医疗保健专业人员和普通民众,通过科学外展期刊和研究机构通讯。
BACKGROUND: Oxygen is frequently prescribed in neurocritical care units. Avoiding hypoxaemia is a key objective in patients with acute brain injury (ABI). However, several studies suggest that hyperoxaemia may also be related to higher mortality and poor neurological outcomes in these patients. The evidence in this direction is still controversial due to the limited number of prospective studies, the lack of a common definition for hyperoxaemia, the heterogeneity in experimental designs and the different causes of ABI. To explore the correlation between hyperoxaemia and poor neurological outcomes and mortality in hospitalised adult patients with ABI, we will conduct a systematic
review and meta-analysis of observational studies and RCTs.
METHODS: The systematic
review methods have been defined according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and follow the PRISMA-Protocols structure. Studies published until June 2024 will be identified in the electronic databases MEDLINE, Embase, Scopus, Web of Science, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature and ClinicalTrials.gov. Retrieved records will be independently screened by four authors working in pairs, and the selected variables will be extracted from studies reporting data on the effect of \'hyperoxaemia\' versus \'no hyperoxaemia on neurological outcomes and mortality in hospitalised patients with ABI. We will use covariate-adjusted ORs as outcome measures when reported since they account for potential cofounders and provide a more accurate estimate of the association between hyperoxaemia and outcomes; when not available, we will use univariate ORs. If the study presents the results as relative risks, it will be considered equivalent to the OR as long as the prevalence of the condition is close to 10%. Pooled estimates of both outcomes will be calculated applying random-effects meta-analysis. Interstudy heterogeneity will be assessed using the I2 statistic; risk of bias will be assessed through Risk Of Bias In Non-Randomised Studies of Interventions, Newcastle-Ottawa or RoB2 tools. Depending on data availability, we plan to conduct subgroup analyses by ABI type (traumatic brain injury, postcardiac arrest, subarachnoid haemorrhage, intracerebral haemorrhage and ischaemic stroke), arterial partial pressure of oxygen values, study quality, study time, neurological scores and other selected clinical variables of interest.
BACKGROUND: Specific ethics approval consent is not required as this is a
review of previously published anonymised data. Results of the study will be shared with the scientific community via publication in a peer-reviewed journal and presentation at relevant conferences and workshops. It will also be shared key stakeholders, such as national or international health authorities, healthcare professionals and the general population, via scientific outreach journals and research institutes\' newsletters.