SSC-COVID19-GUIDELINES
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Intensive Care Medicine
SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES |
Un-edited accepted proof* |
Hemodynamic Support Evidence Summaries:
Table S23. Recommendation 9: Evidence profile: conservative vs. liberal fluid therapy
Outcomes |
№ of |
Relative effect |
Certainty of |
|
participants |
(95% CI) |
the evidence |
|
(studies) |
|
|
All-cause Mortality |
637 |
RR 0.87 |
VERY LOW |
|
(9 RCTs) |
(0.69–1.10) |
|
Serious Adverse Events |
637 |
RR 0.91 |
VERY LOW |
|
(9 RCTs) |
(0.78–1.05) |
|
Meyhoff TS, Møller MH, Hjortrup PB, Cronhjort M, Perner A, Wetterslev J. Lower versus higher fluid volumes during initial management of sepsis - a systematic review with meta-analysis and trial sequential analysis. Chest. 2020 Jan 23. pii: S0012-3692(20)30123-9. doi: 10.1016/j.chest.2019.11.050. [Epub ahead of print] PubMed PMID: 31982391.
© European Society of Intensive Care Medicine and the Society of Critical Care Medicine 2020 |
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Intensive Care Medicine
SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES |
Un-edited accepted proof* |
Table S24. Evidence profile: Recommendation 11: buffered/balanced crystalloids vs. unbalanced crystalloids
Outcomes |
№ of |
Relative effect |
Certainty of |
|
participants |
(95% CI) |
the evidence |
|
(studies) |
|
|
Hospital Mortality |
19,664 |
OR 0.91 |
HIGH |
|
(14 RCTs) |
(0.83–1.01) |
|
Acute Kidney Injury |
18,701 |
RR 0.91 |
LOW |
|
(9 RCTs) |
(0.78–1.05) |
|
Antequera Martín AM, Barea Mendoza JA, Muriel A, Sáez I, Chico-Fernández M, Estrada-Lorenzo JM, Plana MN. Buffered solutions versus 0.9% saline for resuscitation in critically ill adults and children. Cochrane Database Syst Rev. 2019 Jul 19;7:CD012247. doi: 10.1002/14651858.CD012247.pub2. PubMed PMID: 31334842; PubMed Central PMCID: PMC6647932.
© European Society of Intensive Care Medicine and the Society of Critical Care Medicine 2020 |
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Intensive Care Medicine
SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES |
Un-edited accepted proof* |
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Table S25. Evidence profile: Recommendation 12: crystalloids vs. hydroxyethyl starches |
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Outcomes |
№ of |
Relative effect |
Certainty of |
|
participants |
(95% CI) |
the evidence |
|
(studies) |
|
|
All-cause Mortality (end of follow-up) |
11,177 |
RR 0.97 |
MODERATE |
|
(24 RCTs) |
(0.86–1.09) |
|
All-cause Mortality (within 90 days) |
10,415 |
RR 1.01 |
MODERATE |
|
(15 RCTs) |
(0.90–1.14) |
|
All-cause Mortality (within 30 days) |
10,135 |
RR 0.99 |
MODERATE |
|
(11 RCTs) |
(0.90–1.09) |
|
Renal Replacement Therapy |
8,527 |
RR 1.30 |
MODERATE |
|
(9 RCTs) |
(1.14–1.48) |
|
Blood transfusion |
1,917 |
RR 1.19 |
MODERATE |
|
(8 RCTs) |
(1.02–1.39) |
|
Lewis SR, Pritchard MW, Evans DJ, Butler AR, Alderson P, Smith AF, Roberts I. Colloids versus crystalloids for fluid resuscitation in critically ill people. Cochrane Database Syst Rev. 2018 Aug 3;8:CD000567. doi: 10.1002/14651858.CD000567.pub7. PubMed PMID: 30073665; PubMed Central PMCID: PMC6513027.
© European Society of Intensive Care Medicine and the Society of Critical Care Medicine 2020 |
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Intensive Care Medicine
SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES |
Un-edited accepted proof* |
Table S26. Evidence profile: Recommendation 13: crystalloids vs. gelatins
Outcomes |
№ of |
Relative effect |
Certainty of |
|
participants |
(95% CI) |
the evidence |
|
(studies) |
|
|
All-cause Mortality (end of follow-up) |
1,698 |
RR 0.89 |
LOW |
|
(6 RCTs) |
(0.74–1.08) |
|
All-cause Mortality (within 90 days) |
1,388 |
RR 0.89 |
LOW |
|
(1 RCT) |
(0.73–1.09) |
|
All-cause Mortality (within 30 days) |
1,388 |
RR 0.92 |
LOW |
|
(1 RCT) |
(0.74–1.16) |
|
Lewis SR, Pritchard MW, Evans DJ, Butler AR, Alderson P, Smith AF, Roberts I. Colloids versus crystalloids for fluid resuscitation in critically ill people. Cochrane Database Syst Rev. 2018 Aug 3;8:CD000567. doi: 10.1002/14651858.CD000567.pub7. PubMed PMID: 30073665; PubMed Central PMCID: PMC6513027.
© European Society of Intensive Care Medicine and the Society of Critical Care Medicine 2020 |
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Intensive Care Medicine
SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES |
Un-edited accepted proof* |
||
Table S27. Evidence profile: Recommendation 14 crystalloids vs. dextrans |
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Outcomes |
№ of |
Relative effect |
Certainty of |
|
participants |
(95% CI) |
the evidence |
|
(studies) |
|
|
All-cause Mortality (end of follow-up) |
4,736 |
RR 0.99 |
MODERATE |
|
(19 RCTs) |
(0.88–1.11) |
|
All-cause Mortality (within 90 days) |
3,353 |
RR 0.99 |
MODERATE |
|
(10 RCT) |
(0.87–1.12) |
|
Blood transfusion |
1,272 |
RR 0.92 |
VERY LOW |
|
(3 RCTs) |
(0.7–1.10) |
|
Lewis SR, Pritchard MW, Evans DJ, Butler AR, Alderson P, Smith AF, Roberts I. Colloids versus crystalloids for fluid resuscitation in critically ill people. Cochrane Database Syst Rev. 2018 Aug 3;8:CD000567. doi: 10.1002/14651858.CD000567.pub7. PubMed PMID: 30073665; PubMed Central PMCID: PMC6513027.
© European Society of Intensive Care Medicine and the Society of Critical Care Medicine 2020 |
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Intensive Care Medicine
SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES Un-edited accepted proof*
Table S28. Evidence profile: Recommendation 15 crystalloids vs. albumin |
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Outcomes |
№ of |
Relative effect |
Certainty of |
|
participants |
(95% CI) |
the evidence |
|
(studies) |
|
|
All-cause Mortality (end of follow-up) |
13,047 |
RR 0.98 |
MODERATE |
|
(20 RCTs) |
(0.92–1.06) |
|
All-cause Mortality (within 90 days) |
12,492 |
RR 0.98 |
MODERATE |
|
(10 RCTs) |
(0.92–1.04) |
|
All-cause Mortality (within 30 days) |
12,506 |
RR 0.99 |
MODERATE |
|
(10 RCTs) |
(0.93–1.06) |
|
Renal Replacement Therapy |
290 |
RR 1.11 |
VERY LOW |
|
(2 RCTs) |
(0.96–1.27) |
|
Blood transfusion |
1,917 |
RR 1.31 |
VERY LOW |
|
(3 RCTs) |
(0.95–1.80) |
|
Lewis SR, Pritchard MW, Evans DJ, Butler AR, Alderson P, Smith AF, Roberts I. Colloids versus crystalloids for fluid resuscitation in critically ill people. Cochrane Database Syst Rev. 2018 Aug 3;8:CD000567. doi: 10.1002/14651858.CD000567.pub7. PubMed PMID: 30073665; PubMed Central PMCID: PMC6513027.
© European Society of Intensive Care Medicine and the Society of Critical Care Medicine 2020 |
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Intensive Care Medicine
SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES |
Un-edited accepted proof* |
Table S29. Evidence profile: Recommendation 18 norepinephrine vs. dopamine
Outcomes |
№ of |
Relative effect |
Certainty of |
|
participants |
(95% CI) |
the evidence |
|
(studies) |
|
|
All-cause Mortality (end of follow-up) |
1,400 |
RR 1.07 |
HIGH |
|
(6 RCTs) |
(0.99–1.16) |
|
Arrhythmias |
1,931 |
RR 2.34 |
HIGH |
|
(2 RCTs) |
(1.46–3.78) |
|
Gamper G, Havel C, Arrich J, Losert H, Pace NL, Müllner M, Herkner H. Vasopressors for hypotensive shock. Cochrane Database Syst Rev. 2016 Feb 15;2:CD003709. doi: 10.1002/14651858.CD003709.pub4. Review. PubMed PMID: 26878401; PubMed Central PMCID: PMC6516856.
© European Society of Intensive Care Medicine and the Society of Critical Care Medicine 2020 |
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Intensive Care Medicine
SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES |
Un-edited accepted proof* |
Table S30. Evidence profile: Recommendation 19 vasopressin add-on vs. norepinephrine
Outcomes |
№ of |
Relative effect |
Certainty of |
|
participants |
(95% CI) |
the evidence |
|
(studies) |
|
|
All-cause Mortality (end of follow-up) |
3,430 |
RR 0.91 |
LOW |
|
(18 RCTs) |
(0.85–0.99) |
|
Atrial Fibrillation |
1,358 |
RR 0.77 |
HIGH |
|
(13 RCT) |
(0.67–0.88) |
|
Digital Ischemia |
2,489 |
RR 2.56 |
MODERATE |
|
(10 RCTs) |
(1.24–5.25) |
|
Honarmand K, Um KJ, Belley-Côté EP, Alhazzani W, Farley C, Fernando SM, Fiest K, Grey D, Hajdini E, Herridge M, Hrymak C, Møller MH, Kanji S, Lamontagne F, Lauzier F, Mehta S, Paunovic B, Singal R, Tsang JL, Wynne C, Rochwerg B. Canadian Critical Care Society clinical practice guideline: The use of vasopressin and vasopressin analogues in critically ill adults with distributive shock. Can J Anaesth. 2020 Mar;67(3):369-376. doi: 10.1007/s12630-019-01546-x. Epub 2019 Dec 3. PubMed PMID: 31797234.
© European Society of Intensive Care Medicine and the Society of Critical Care Medicine 2020 |
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Intensive Care Medicine
SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES Un-edited accepted proof*
Table S31. Evidence profile: Recommendation 20 higher vs. lower MAP targets |
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Outcomes |
№ of participants |
Relative effect |
Certainty of |
|
(studies) |
(95% CI) |
the evidence |
28-day Mortality |
894 |
OR 1.15 |
LOW |
|
(2 RCTs) |
(0.87 to 1.52) |
|
90-day Mortality |
894 |
OR 1.08 |
LOW |
|
(2 RCTs) |
(0.84 to 1.44) |
|
Supraventricular Arrhythmia |
894 |
OR 2.50 |
MODERATE |
|
(2 RCTs) |
(1.35–4.77) |
|
Myocardial Injury |
894 |
OR 1.47 |
LOW |
|
(2 RCTs) |
(0.64–3.56) |
|
Limb Ischemia |
894 |
OR 0.92 |
LOW |
|
(2 RCTs) |
(0.36–2.10) |
|
© European Society of Intensive Care Medicine and the Society of Critical Care Medicine 2020 |
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Intensive Care Medicine
SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES |
Un-edited accepted proof* |
Table S32. Evidence profile: Recommendation 22 corticosteroids vs. no corticosteroids in shock
Outcomes |
№ of |
Relative effect |
Certainty of |
|
participants |
(95% CI) |
the evidence |
|
(studies) |
|
|
Short-term Mortality (<90 days) |
7297 |
RR 0.96 |
HIGH |
|
(22 RCTs) |
(0.91–1.02) |
|
Long-term Mortality (>90 days) |
5667 |
RR 0.96 |
MODERATE |
|
(5 RCTs) |
(0.90–1.02) |
|
Serious Adverse Events |
5908 |
RR 0.98 |
LOW |
|
(10 RCTs) |
(0.90–1.08) |
|
© European Society of Intensive Care Medicine and the Society of Critical Care Medicine 2020 |
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