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Meta-Analysis
. 2018 Sep;97(38):e12406.
doi: 10.1097/MD.0000000000012406.

Effect of high-volume hemofiltration on mortality in critically ill patients: A PRISMA-compliant systematic review and meta-analysis

Yusheng Luo  1 , Guijun Sun, Cailian Zheng, Mei Wang, Juan Li, Jie Liu, Yuqiang Chen, Wei Zhang, Yanling Li
Affiliations
Meta-Analysis

Effect of high-volume hemofiltration on mortality in critically ill patients: A PRISMA-compliant systematic review and meta-analysis

Yusheng Luo et al. Medicine (Baltimore). 2018 Sep.

Abstract

Background: High-volume hemofiltration (HVHF) is widely used for blood purification in critically ill patients with systemic inflammatory syndromes. The purpose of this study was to evaluate the effect of HVHF on mortality at different follow-up periods in critically ill patients.

Methods: We systematically searched PubMed, Embase, and the Cochrane Library through April 2017 to identify trials that evaluated the effect of HVHF on mortality in critically ill patients. Summary relative risks (RRs) and 95% confidence intervals (CIs) were employed to calculate the treatment effect using a random effects model. Eleven trials involving 1048 critically ill patients were included in this study.

Results: The summary results indicated no significant differences between HVHF and usual care for the incidence of 28-day mortality (RR: 0.93; 95%CI: 0.80-1.08; P = .321), 7-day mortality (RR: 0.72; 95%CI: 0.50-1.03; P = .072), 60-day mortality (RR: 1.00; 95%CI: 0.86-1.16; P = .997), and 90-day mortality (RR: 1.01; 95%CI: 0.88-1.16; P = .927). Subgroup analysis suggested HVHF significantly reduced the risk of 28-day mortality (RR: 0.64; 95%CI: 0.42-0.97; P = .035) if pooled the study sample size < 100.

Conclusion: Our findings suggest HVHF significantly reduced the incidence of 28-day mortality when pooled the study sample size < 100. Further, HVHF had a marginal effect on the incidence of 7-day mortality.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Study selection process.
Figure 2
Figure 2
Effect of HVHF on the incidence of 28-days mortality. HVHF = high-volume hemofiltration.
Figure 3
Figure 3
Effect of HVHF on the incidence of 7-days mortality (A), 60-days mortality (B), and 90-days mortality (C). HVHF = high-volume hemofiltration.
Figure 4
Figure 4
Funnel plot for 28-days mortality. HVHF = high-volume hemofiltration.
See this image and copyright information in PMC

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