Cochrane · systematic review · CD006832
Interventions for preventing critical illness polyneuropathy and critical illness myopathy
Hermans, G, De Jonghe, B, Bruyninckx, F, et al. · Cochrane Database of Systematic Reviews · 2014 · Cochrane Library
NeuromuscularAMSTAR 2: not assessed
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
19
current version
GRADE rated
19
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 2 · 10.5%Low 3 · 15.8%Moderate 5 · 26.3%High 9 · 47.4%
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
Intensive insulin therapy versus conventional insulin therapy for preventing critical illness polyneuropathy and critical illness myopathy
Population: critically ill patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Occurrence of CIP/CIM ‐ in total population randomised Intensive insulin therapy vs conventional insulin therapy | RR 0.7 [0.6, 0.82] | 2 studies · 2748 participants | Low Downgraded: inconsistency |
Occurrence of CIP/CIM ‐ in screened population Intensive insulin therapy vs conventional insulin therapy | RR 0.65 [0.55, 0.77] | 2 studies · 825 participants | Moderate Downgraded: inconsistency |
Duration of mechanical ventilation ‐ in total population randomised (in days) Intensive insulin therapy vs conventional insulin therapy | no estimate extracted | 2 studies · 2748 participants | High |
Duration of ICU stay ‐ in total population randomised (in days) Intensive insulin therapy vs conventional insulin therapy | no estimate extracted | 2 studies · 2748 participants | High |
Death ‐ at 30 days after ICU admission, in total population randomised Intensive insulin therapy vs conventional insulin therapy | RR 0.94 [0.8, 1.1] | 2 studies · 2748 participants | High |
Death ‐ at 180 days after ICU admission, in total population randomised Intensive insulin therapy vs conventional insulin therapy | RR 0.87 [0.76, 1] | 2 studies · 2748 participants | Moderate Downgraded: inconsistency |
Serious adverse events, ‐ in total population randomised ‐ hypoglycaemia Intensive insulin therapy vs conventional insulin therapy | RR 6.27 [4.15, 9.49] | 2 studies · 2748 participants | High |
Corticosteroids versus placebo compared for preventing critical illness polyneuropathy and critical illness myopathy
Population: critically ill patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Occurrence of CIP/CIM ‐ in total population randomised Corticosteroids vs placebo compared | RR 1.27 [0.77, 2.08] | 1 study · 180 participants | Low |
Occurrence of CIP/CIM ‐ in screened population Corticosteroids vs placebo compared | RR 1.09 [0.53, 2.26] | 1 study · 92 participants | Moderate |
Death ‐ death at 180 days in total population randomised Corticosteroids vs placebo compared | RR 0.99 [0.64, 1.52] | 1 study · 180 participants | High |
Serious adverse events (dichotomous data) ‐ shock Corticosteroids vs placebo compared | RR 0.41 [0.17, 1.01] | 1 study · 180 participants | High |
Serious adverse events (dichotomous data) ‐ serious infection Corticosteroids vs placebo compared | RR 0.68 [0.42, 1.11] | 1 study · 180 participants | High |
Serious adverse events (dichotomous data) ‐ suspected or probable pneumonia Corticosteroids vs placebo compared | RR 0.44 [0.18, 1.09] | 1 study · 180 participants | High |
Serious adverse events (continuous data) ‐ blood glucose (mg/dL) on day 7 Corticosteroids vs placebo compared | no estimate extracted | 1 study · 180 participants | High |
Early physical therapy versus control for preventing critical illness polyneuropathy and critical illness myopathy
Population: critically ill patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Occurrence of CIP/CIM ‐ in the total population randomised Early physical therapy vs control | RR 0.81 [0.6, 1.08] | 1 study · 104 participants | Low |
Occurrence of CIP/CIM ‐ in screened population Early physical therapy vs control | RR 0.62 [0.39, 0.96] | 1 study · 82 participants | Moderate |
Serious adverse events ‐ in total population randomised Early physical therapy vs control | RR 3.36 [0.14, 80.62] | 1 study · 104 participants | Moderate |
Electrical muscle stimulation versus control for preventing critical illness polyneuropathy and critical illness myopathy
Population: critically ill patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Occurrence of CIP/CIM ‐ in the total population randomised Electrical muscle stimulation vs control | RR 0.94 [0.78, 1.15] | 1 study · 140 participants | Very low Downgraded: risk of bias, imprecision |
Occurrence of CIP/CIM ‐ in screened population Electrical muscle stimulation vs control | RR 0.32 [0.1, 1.01] | 1 study · 52 participants | Very low Downgraded: risk of bias, imprecision |