| Popis: |
BackgroundIntravenous fluid therapy is ubiquitous in intensive care units (ICUs). There is increasing recognition of the value of restrictive fluid management strategies, including improved survival and renal function. However, these strategies have not been universally adopted. The purpose of this protocol is to outline our plan for investigating the current literature on the topic of restrictive versus liberal fluid management strategies in all critically ill adults and their associated outcomes, namely major adverse kidney events (MAKE). Methods We will conduct a systematic review and meta-analysis of randomized controlled trials evaluating fluid management strategies in critically ill adults. A search strategy was created with the help of medical librarians, using Ovid MEDLINE, PubMed, EMBASE, CINAHL, Web of Science, and The Cochrane Library. Four independent researchers will perform study selection and data extraction in duplicate. The primary outcome of this study is detection of MAKE by 30 days. Secondary outcomes include reporting MAKE at 60 and 90 days; and mortality, new onset renal replacement therapy, and persistent renal dysfunction at 30, 60, and 90 days. If appropriate, we will perform a meta-analysis using a DerSimonian and Laird random-effects model. Subgroups will include patient type, ICU type, and study quality. Certainty of evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation approach.DiscussionThe results of this study will synthesize current evidence and better inform the optimal fluid management strategy in critically ill adults.Systematic review registration: Submitted to PROSPERO on June 16th, 2021. |
