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致编辑的信:对最近发表的一项关于氧疗的荟萃分析存在严重的方法学担忧。

Letter the editor: serious methodological concerns about a recently published meta-analysis on oxygen therapy.

作者信息

Klitgaard Thomas Lass, Schjørring Olav Lilleholt, Nielsen Frederik Mølgaard, Meyhoff Christian Sylvest, Barbateskovic Marija, Wetterslev Jørn, Perner Anders, Rasmussen Bodil Steen

机构信息

Department of Anaesthesia and Intensive Care, Aalborg University Hospital, Aalborg, Denmark.

Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

出版信息

J Intensive Care. 2021 Dec 7;9(1):72. doi: 10.1186/s40560-021-00573-5.

DOI:10.1186/s40560-021-00573-5
PMID:34876227
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8649324/
Abstract

In a recent paper, Chen et al. report the findings of a systematic review with meta-analysis concerning conservative versus conventional oxygen therapy for critically ill patients. We wish to commend the authors for their interest in the matter. However, the authors appear to misquote findings, fail to report results for all specified analyses, do not identify all relevant trials, have post hoc changed the eligibility criteria, and have seemingly switched directions of effects in analyses of secondary outcomes. These issues have led to incorrect conclusions concerning the effects of targeted oxygen therapy in critically ill patients.

摘要

在最近的一篇论文中,陈等人报告了一项关于危重症患者保守氧疗与传统氧疗的系统评价及荟萃分析的结果。我们赞赏作者对该问题的关注。然而,作者似乎错误引用了研究结果,未报告所有指定分析的结果,未识别所有相关试验,事后更改了纳入标准,并且在次要结局分析中似乎改变了效应方向。这些问题导致了关于危重症患者目标导向性氧疗效果的错误结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffb2/8650383/390b63b90844/40560_2021_573_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffb2/8650383/3de7a56f0d36/40560_2021_573_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffb2/8650383/fdd2cf890353/40560_2021_573_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffb2/8650383/ab01bb9007bc/40560_2021_573_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffb2/8650383/09e78519bd47/40560_2021_573_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffb2/8650383/390b63b90844/40560_2021_573_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffb2/8650383/3de7a56f0d36/40560_2021_573_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffb2/8650383/fdd2cf890353/40560_2021_573_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffb2/8650383/ab01bb9007bc/40560_2021_573_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffb2/8650383/09e78519bd47/40560_2021_573_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffb2/8650383/390b63b90844/40560_2021_573_Fig5_HTML.jpg

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本文引用的文献

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Conservative oxygen therapy for critically ill patients: a meta-analysis of randomized controlled trials.危重症患者的保守氧疗:随机对照试验的荟萃分析
J Intensive Care. 2021 Jul 22;9(1):47. doi: 10.1186/s40560-021-00563-7.
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Lower or Higher Oxygenation Targets for Acute Hypoxemic Respiratory Failure.急性低氧性呼吸衰竭的低氧或高氧目标。
N Engl J Med. 2021 Apr 8;384(14):1301-1311. doi: 10.1056/NEJMoa2032510. Epub 2021 Jan 20.
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N Engl J Med. 2020 Mar 12;382(11):999-1008. doi: 10.1056/NEJMoa1916431.
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Higher versus lower fraction of inspired oxygen or targets of arterial oxygenation for adults admitted to the intensive care unit.入住重症监护病房的成人患者吸入氧分数较高与较低水平或动脉氧合目标的比较。
Cochrane Database Syst Rev. 2019 Nov 27;2019(11):CD012631. doi: 10.1002/14651858.CD012631.pub2.
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Low versus high pulse oxygen saturation directed oxygen therapy in critically ill patients: a randomized controlled pilot study.危重症患者低与高脉搏血氧饱和度目标导向性氧疗:一项随机对照试验性研究
J Thorac Dis. 2019 Oct;11(10):4234-4240. doi: 10.21037/jtd.2019.09.66.
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Conservative Oxygen Therapy during Mechanical Ventilation in the ICU.ICU 机械通气时的保守氧疗。
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Targeting two different levels of both arterial carbon dioxide and arterial oxygen after cardiac arrest and resuscitation: a randomised pilot trial.心脏骤停与复苏后靶向动脉二氧化碳和动脉氧的两个不同水平:一项随机先导试验。
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Hyperoxia and hypertonic saline in patients with septic shock (HYPERS2S): a two-by-two factorial, multicentre, randomised, clinical trial.高氧和高渗盐水治疗脓毒性休克患者(HYPERS2S):一项两因素、多中心、随机、临床试验。
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Effect of Conservative vs Conventional Oxygen Therapy on Mortality Among Patients in an Intensive Care Unit: The Oxygen-ICU Randomized Clinical Trial.保守与常规吸氧治疗对重症监护病房患者死亡率的影响:氧气 ICU 随机临床试验。
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