Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: A systematic review of randomized controlled trials exploring the effect of immunomodulative interventions on infection, organ failure, and mortality in trauma patients. | Spruijt et al. Critical Care 2010 14 R150 http content 14 4 R150 c CRITICAL CARE RESEARCH Open Access A systematic review of randomized controlled trials exploring the effect of immunomodulative interventions on infection organ failure and mortality in trauma patients Nicole E Spruijt Tjaakje Visser Luke PH Leenen Abstract Introduction Following trauma patients may suffer an overwhelming pro-inflammatory response and immune paralysis resulting in infection and multiple organ failure MOF . Various potentially immunomodulative interventions have been tested. The objective of this study is to systematically review the randomized controlled trials RCTs that investigate the effect of potentially immunomodulative interventions in comparison to a placebo or standard therapy on infection MOF and mortality in trauma patients. Methods A computerized search of MEDLINE the Cochrane CENTRAL Register of Controlled Trials and EMBASE yielded 502 studies of which 18 unique RCTs were deemed relevant for this study. The methodological quality of these RCTs was assessed using a critical appraisal checklist for therapy articles from the Centre for Evidence Based Medicine. The effects of the test interventions on infection MOF and mortality rates and inflammatory parameters relative to the controls were recorded. Results In most studies the inflammatory parameters differed significantly between the test and control groups. However significant changes in infection MOF and mortality rates were only measured in studies testing immunoglobulin IFN-y and glucan. Conclusions Based on level 1b and 2b studies administration of immunoglobulin IFN-y or glucan have shown the most promising results to improve the outcome of trauma patients. Introduction Trauma remains the leading cause of death in people under the age of 40 years 1 with multiple organ failure MOF accounting for of deaths among trauma patients 2 . MOF can be a result of an early over-reaction of the immune system or
