Fibrinolytic therapy in patients with COVID-19 and ARDS: protocol for a systematic review and meta-analysis.

Autor:	Savioli F; Critical Care Medicine, Hospital Sirio-Libanes, Sao Paulo, Brazil feasavioli@gmail.com.; Evidence Based Medicine, Universidade Federal de Sao Paulo, Sao Paulo, Brazil., Ribeiro Dos Santos L; Evidence Based Medicine, Universidade Federal de Sao Paulo, Sao Paulo, Brazil., Duarte ML; Evidence Based Medicine, Universidade Federal de Sao Paulo, Sao Paulo, Brazil., Feitosa do Carmo AC; Evidence Based Medicine, Universidade Federal de Sao Paulo, Sao Paulo, Brazil., Gois A; Evidence Based Medicine, Universidade Federal de Sao Paulo, Sao Paulo, Brazil., Nakano L; Evidence Based Medicine, Universidade Federal de Sao Paulo, Sao Paulo, Brazil., Da Silva Ramos FJ; Critical Care Medicine, Hospital Sirio-Libanes, Sao Paulo, Brazil., Pastore L; Critical Care Medicine, Hospital Sirio-Libanes, Sao Paulo, Brazil., Costa ELV; Critical Care Medicine, Hospital Sirio-Libanes, Sao Paulo, Brazil.; Cardiopulmonary Medicine, Faculdade de Medicina Universidade de Sao Paulo, Sao Paulo, Brazil.; Instituto Sirio-Libanes de Ensino e Pesquisa, Sao Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 Jan 02; Vol. 13 (1), pp. e066623. Date of Electronic Publication: 2023 Jan 02.
DOI:	10.1136/bmjopen-2022-066623
Abstrakt:	Introduction: In COVID-19-related acute respiratory distress syndrome (ARDS), the clot play a role in gas exchange abnormalities. Fibrinolytic therapy can improve alveolar ventilation by restoring blood flow. In this systematic review and meta-analysis protocol, we aim to assess the safety and efficacy of fibrinolytic therapy in such a population. Methods: We will perform a systematic search in MEDLINE, EMBASE, Cochrane CENTRAL and LILACS databases without language restrictions for relevant randomised controlled trials (RCTs) and quasi-RCTs. Two review authors will independently perform data extraction and quality assessments of data from included studies. In case of divergence, a third author will be contacted. The Cochrane handbook will be used for guidance. If the results are not appropriate for a meta-analysis, a descriptive analysis will be performed. Discussion: This systematic review and meta-analysis protocol will provide current evidence about the safety and efficacy of fibrinolytic therapy in patients with COVID-19 and ARDS. These findings will provide if fibrinolytic therapy might be an option for a desperate clinical setting, where all medical efforts have been used. Prospero Registration Number: PROSPERO CRD42020187482. Ethics and Dissemination: Ethics committee approval is not necessary. We intend to update the public registry, report any protocol amendments and publish the results in a widely accessible journal. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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