Meta AnalysisID 3717
肾上腺素和去甲肾上腺素与其他正性肌力药在儿科急诊科休克患儿治疗中的比较：一项系统评价与Meta分析
CRD42021255259
: To assess the efficacy and the safety of using of epinephrine and norepinephrine in children with shock in the emergency department compared to the other inotropes in children aged less 18 years old.
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Record Fields
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- Meta Analysis Id
- 3717
- Evidence Id
- 12275
- Core Evidence Id
- 12275
- Source Meta Analysis Id
- 3675
- Herb2 Meta Analysis Id
- HBMA003675
- Crd Id
- CRD42021255259
- Title
- The use of epinephrine and norepinephrine compared with other inotropes in treatment of children with shock in the Paediatric Emergency Department- A systemic review and meta- analysis
- Review Question
- : To assess the efficacy and the safety of using of epinephrine and norepinephrine in children with shock in the emergency department compared to the other inotropes in children aged less 18 years old.
- Study Type Included
- We will include only randomized controlled trials (RCTs) conducted in the emergency department that compared the management of children with shock using epinephrine and/or norepinephrine with the other inotropes or any other treatment modalities.
- Condition Being Studied
- Shock results in hypoxia, impaired organ perfusion and metabolic derangements, which cause cellular injury. Early injury is often reversible, persistent hypo-perfusion leads to irreversible tissue damage, progressive organ failure and progression to death (Mitchell R N 2012). Paediatric shock is a common life-threating illness that requires prompt recognition and correction. It accounts to a significant morbidity and mortality rate worldwide. Depending on the etiology, the mortality is between 25-57% for some causes (Mc Caig 2002, Prasad A 2004). . The aim of the shock correction is to restore balance of the 3 main systems; the pump (cardiac output), transport system (peripheral circulation) and transport media (blood volume). Inotropes have been used for the treatment of shock for a long time to improve the hemodynamic and to restore tissue perfusion. It is usually used in cases of fluid refractory shock. The choice of which inotropes medication to use depends on the aetiology and type of shock occurring in patient (Van Valkinburgh 2021) .
- Participant
- Will include children aged from 1 month to 18 years who are treated for shock in the emergency department. We will exclude: children who were already treated with inotropes by the EMS crew on their way to the hospital.
- Animal
- Human Disease Modelled
- Intervention
- The use of epinephrine and norepinephrine in treatment of children with shock in ED
- Comparator Control
- The use of the other inotropes
- Main Outcome
- All-cause mortality Measures of effect We will report the risk ratio (RR) for dichotomous data. We will calculate the mean difference (MD) or standardized mean difference (SMD) for continuous data. Randomized controlled trials will be assessed in this review. We will report the participant patients who needed acute treatment for shock as the unit of analysis. For the study with non-standard design (for example cross-over trials, cluster-randomized trials) data synthesis will be handled according to the standards outlined by the Cochrane handbook for Systemic Review of Interventions.
- Outcome Measure
- Additional Outcome
- - Need for the second vasoactive drug - Severe adverse reactions including cardiac arrhythmias - Effects on urinary output, blood lactate level, central venous pressure Measures of effect We will report the risk ratio (RR) for dichotomous data. We will calculate the mean difference (MD) or standardized mean difference (SMD) for continuous data. Randomized controlled trials will be assessed in this review. We will report the participant patients who needed acute treatment for shock as the unit of analysis. For the study with non-standard design (for example cross-over trials, cluster-randomized trials) data synthesis will be handled according to the standards outlined by the Cochrane handbook for Systemic Review of Interventions.
- Study Method
- Meta-analysis, Systematic review
- Keyword
- Child; Emergency Service, Hospital; Epinephrine; Humans; Norepinephrine
- Contact
- Ahmed Shamekh [email protected]
- Organisational Affiliation
- Sidra Medicine, Doha, Qatar
- Funding Source
- NA Grant number(s) <span style=font-size: 14px>State the funder, grant or award number and the date of award</span> NA
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- Qatar
- Review Stage
- Review Ongoing
- First Submission Date
- 2021-05-27
- Registration Date
- 2021-06-27
- Anticipated Start Date
- 2021-08-01
- Anticipated Completion Date
- 2022-01-12
- Title Cn
- 肾上腺素和去甲肾上腺素与其他正性肌力药在儿科急诊科休克患儿治疗中的比较：一项系统评价与Meta分析
- Title En
- The use of epinephrine and norepinephrine compared with other inotropes in treatment of children with shock in the Paediatric Emergency Department- A systemic review and meta- analysis
- Bilingual Status
- complete