Cochrane · systematic review · CD003004
Perioperative fluid volume optimization following proximal femoral fracture
Lewis, SR, Butler, AR, Brammar, A, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
15
No studies
2
Included studies
NR
No studies 2 · 9.5%Ungraded 4 · 19%Very low 2 · 9.5%Low 12 · 57.1%Moderate 1 · 4.8%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyAdvanced haemodynamic monitoring compared with protocol using standard measures such as CVP for proximal femoral fracture
Population: patients with proximal femoral fracture
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality Advanced haemodynamic monitoring Advanced haemodynamic monitoring vs protocol using standard measures such | RR 0.41 [0.14, 1.2] | 3 studies · 280 participants | Very low Downgraded: risk of bias, imprecision |
Total length of hospital stay Advanced haemodynamic monitoring vs protocol using standard measures such | no estimate extracted | 2 studies · 203 participants | Low Downgraded: imprecision |
Medically fit for discharge Advanced haemodynamic monitoring vs protocol using standard measures such | no estimate extracted | 1 study · 90 participants | Low Downgraded: risk of bias, imprecision |
Return to pre‐fracture accommodation/return to pre‐fracture mobility Advanced haemodynamic monitoring vs protocol using standard measures such | no estimate extracted | NR | No studies |
Adverse outcomes ‐ cardiopulmonary Advanced haemodynamic monitoring vs protocol using standard measures such | no estimate extracted | 0 studies · 0 participants | Ungraded |
Adverse outcomes ‐ neurological Advanced haemodynamic monitoring vs protocol using standard measures such | no estimate extracted | 0 studies · 0 participants | Ungraded |
Adverse outcomes ‐ all Advanced haemodynamic monitoring vs protocol using standard measures such | RR 0.9 [0.37, 2.18] | 3 studies · 280 participants | Very low Downgraded: risk of bias, imprecision |
Advanced haemodynamic monitoring compared with usual care for perioperative fluid optimization
Population: patients with perioperative fluid optimization
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality Advanced haemodynamic monitoring vs usual care | RR 0.45 [0.07, 2.95] | 3 studies · 213 participants | Low |
Total length of hospital stay Advanced haemodynamic monitoring vs usual care | no estimate extracted | 2 studies · 175 participants | Low |
Medically fit for discharge Advanced haemodynamic monitoring vs usual care | no estimate extracted | 2 studies · 175 participants | Low |
Return to pre‐fracture accommodation/return to pre‐fracture mobility Advanced haemodynamic monitoring vs usual care | no estimate extracted | 1 study · 114 participants | Low |
Adverse outcomes ‐ cardiopulmonary Advanced haemodynamic monitoring vs usual care | no estimate extracted | 0 studies · 0 participants | Ungraded |
Adverse outcomes ‐ neurological Advanced haemodynamic monitoring vs usual care | RR 1.1 [0.56, 2.18] | 2 studies · 173 participants | Low |
Adverse outcomes ‐ all Advanced haemodynamic monitoring vs usual care | RR 0.78 [0.57, 1.05] | 2 studies · 173 participants | Low |
Protocol using standard measures such as CVP compared with usual care for perioperative fluid optimization
Population: patients with perioperative fluid optimization
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality Protocol using standard measures such as CVP vs usual care | RR 2.81 [0.61, 12.81] | 1 study · 60 participants | Low Downgraded: imprecision |
Total length of hospital stay Protocol using standard measures such as CVP vs usual care | no estimate extracted | 1 study · 60 participants | Low Downgraded: imprecision |
Medically fit for discharge Protocol using standard measures such as CVP vs usual care | no estimate extracted | 1 study · 60 participants | Moderate Downgraded: imprecision |
Return to pre‐fracture accommodation/return to pre‐fracture mobility Protocol using standard measures such as CVP vs usual care | no estimate extracted | NR | No studies |
Adverse outcomes ‐ cardiopulmonary Protocol using standard measures such as CVP vs usual care | no estimate extracted | 0 studies · 0 participants | Ungraded |
Adverse outcomes ‐ neurological Protocol using standard measures such as CVP vs usual care | RR 0.94 [0.06, 14.27] | 1 study · 60 participants | Low Downgraded: imprecision |
Adverse outcomes ‐ all Protocol using standard measures such as CVP vs usual care | RR 0.53 [0.26, 1.08] | 1 study · 60 participants | Low Downgraded: imprecision |
Advanced haemodynamic monitoring compared with protocol using standard measures for perioperative fluid volume optimisation
Population: patients with proximal femoral fracture
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality Advanced haemodynamic monitoring vs protocol using standard measures | RR 0.52 [0.14, 1.88] | 1 study · 61 participants | Low Downgraded: imprecision |
Total length of hospital stay Advanced haemodynamic monitoring vs protocol using standard measures | no estimate extracted | 1 study · 61 participants | Low Downgraded: imprecision |
Time to medical fitness for discharge Advanced haemodynamic monitoring vs protocol using standard measures | no estimate extracted | 1 study · 61 participants | Low Downgraded: imprecision |
Adverse outcomes Cardiopulmonary－not reported Advanced haemodynamic monitoring vs protocol using standard measures | no estimate extracted | NR | No studies |
Adverse outcomes－neurological Advanced haemodynamic monitoring vs protocol using standard measures | RR 2.07 [0.2, 21.61] | 1 study · 61 participants | Low Downgraded: imprecision |
Advanced haemodynamic monitoring compared with usual care for perioperative fluid optimization
Population: patients with proximal femoral fracture
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality Advanced haemodynamic monitoring vs usual care | RR 1.03 [0.23, 4.66] | 2 studies · 99 participants | Low Downgraded: imprecision |
Total length of hospital stay Advanced haemodynamic monitoring vs usual care | no estimate extracted | 1 study · 59 participants | Low Downgraded: imprecision |
Time to medical fitness for discharge Advanced haemodynamic monitoring vs usual care | no estimate extracted | 1 study · 59 participants | Moderate Downgraded: imprecision |
Adverse outcomes Cardiopulmonary－not reported Advanced haemodynamic monitoring vs usual care | no estimate extracted | NR | No studies |
Adverse outcomes－neurological Advanced haemodynamic monitoring vs usual care | RR 1.93 [0.19, 20.18] | 1 study · 59 participants | Low Downgraded: imprecision |
Protocol using standard measures such as CVP compared with usual care for perioperative fluid optimization
Population: patients with proximal femoral fracture
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality Protocol using standard measures such as CVP vs usual care | RR 2.81 [0.61, 12.81] | 1 study · 60 participants | Low Downgraded: imprecision |
Total length of hospital stay Protocol using standard measures such as CVP vs usual care | no estimate extracted | 1 study · 57 participants | Low Downgraded: imprecision |
Time to medical fitness for discharge Protocol using standard measures such as CVP vs usual care | no estimate extracted | 1 study · 57 participants | Moderate Downgraded: imprecision |
Adverse outcomes Cardiopulmonary－not reported Protocol using standard measures such as CVP vs usual care | no estimate extracted | NR | No studies |
Adverse outcomes－neurological Protocol using standard measures such as CVP vs usual care | RR 0.94 [0.06, 14.27] | 1 study · 60 participants | Low Downgraded: imprecision |