Systematic review with meta-analysis: automated low-flow ascites pump therapy for refractory ascites

2019 ◽  
Vol 50 (9) ◽  
pp. 978-987 ◽  
Author(s):  
Antonia Lepida ◽  
Astrid Marot ◽  
Eric Trépo ◽  
Delphine Degré ◽  
Christophe Moreno ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Low Flow ◽  
Refractory Ascites ◽  
Pump Therapy ◽  
Automated Low Flow

scholarly journals Automated low-flow ascites pump for the treatment of cirrhotic patients with refractory ascites

2017 ◽  
Vol 10 (2) ◽  
pp. 283-292 ◽  
Author(s):  
Guido Stirnimann ◽  
Vanessa Banz ◽  
Federico Storni ◽  
Andrea De Gottardi
Keyword(s):  
Low Flow ◽  
Refractory Ascites ◽  
Organ Shortage ◽  
Efficacy And Safety ◽  
Novel Treatments ◽  
Intrahepatic Portosystemic Shunt ◽  
Cirrhotic Patients ◽  
Large Volume Paracentesis ◽  
Volume Controlled ◽  
Automated Low Flow

Cirrhotic patients with refractory ascites (RA) can be treated with repeated large volume paracentesis (LVP), with the insertion of a transjugular intrahepatic portosystemic shunt (TIPS) or with liver transplantation. However, side effects and complications of these therapeutic options, as well as organ shortage, warrant the development of novel treatments. The automated low-flow ascites pump (alfapump®) is a subcutaneously-implanted novel battery-driven device that pumps ascitic fluid from the peritoneal cavity into the urinary bladder. Ascites can therefore be aspirated in a time- and volume-controlled mode and evacuated by urination. Here we review the currently available data about patient selection, efficacy and safety of the alfapump and provide recommendations for the management of patients treated with this new method.

scholarly journals High-flow oxygen nasal cannula for treating acute bronchiolitis in infants: A systematic review and meta-analysis

Medwave ◽  
2021 ◽  
Vol 21 (04) ◽  
pp. e8190-e8190
Author(s):  
Fernando Tortosa ◽  
Ariel Izcovich ◽  
Gabriela Carrasco ◽  
Gabriela Varone ◽  
Pedro Haluska ◽  
...  
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Treatment Failure ◽  
Meta Analysis ◽  
High Flow ◽  
Nasal Cannula ◽  
Low Flow ◽  
Acute Bronchiolitis ◽  
High Flow Oxygen ◽  
Flow Group

Introduction Oxygen therapy through a high-flow nasal cannula is thought to improve the work of breathing and the comfort of patients with acute bronchiolitis. It is widely used in hospital wards and critical care of pediatric patients. However, there is uncertainty on the magnitude of the effect on critical and important outcomes in these patients. Objectives The objective of this review is to evaluate the available evidence on the use of oxygen administered through high-flow cannula versus low-flow oxygen for the treatment of acute bronchiolitis in children under two years of age. Methodology We carried out a systematic review and a meta-analysis following the PRISMA standards for reporting. The search was carried out in electronic databases by two researchers independently. The evidence was summarized using the GRADE methodology. Results Six randomized and non-randomized clinical trials were included, including 1867 individuals younger than 24 months of age with acute bronchiolitis in pediatric emergency, hospitalization, and intensive care services. Mortality was not reported in the included studies. Treatment failure occurred in 108/933 in the high flow group and 233/934 in the low flow group (relative risk: 0.46; 95% confidence interval: 0.35 to 0.62), which shows 11.7% less treatment failure (95% confidence interval between 7.9% and 14.5% less) in the high flow group with a number needed to treat of 7.5 (95% confidence interval 6 to 10) with moderate certainty in the evidence. Conclusion The use of humidified and heated oxygen with high flow compared to oxygen at low flow is probably associated with decreased treatment failure in children younger than two years with acute bronchiolitis. There is uncertainty about the effect on hospitalization days and clinical progression.

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