Résumé
Objective To evaluate the effect of levosimendan on prognosis and circulation disorders of sepsis patients. Methods With the guidance of these following Chinese or English key words, such as sepsis, severe sepsis, septic shock, simendan, levosimendan, etc., some of Chinese and foreign published literatures on randomized controlled trials (RCTs) concerning the effects of levosimendan on the prognosis and circulatory function of septic patients were searched through China National Knowledge Infrastructure (CNKI) internet, VIP and Wanfang Databases, China Biomedicine Database (CMB), Pubmed in American National library, Holland Medical Abstract Database (Embase), Cochrane Library, etc databases, from the creation of above various databases to May 2017. The quality of the collected RCTs was evaluated by modified Jadad score; Revman 5.3 software was used to carry out Meta analysis; the publication bias was assessed by the funnel plots. Results A total of 18 RCTs, 9 in Chinese and 9 in English, but only half of the literatures were of high quality, and the other 9 of low quality, containing 688 cases in control group and 704 cases in experimental group were ultimately enrolled in this analysis. The Meta analyses showed that there was no statistical significant difference in the mortality between the experimental group and the control group [relative risk (RR) = 0.92, 95% confidence interval (95%CI) = 0.80 - 1.06, P = 0.27]; compared with control group, the time of stay in ICU was shortened [mean difference (MD) = -2.02, 95%CI = -2.90 to -1.13, P < 0.000 01], cardic output index was increased (MD = 0.63, 95%CI = 0.39 - 0.87, P < 0.000 01), and blood lactate level was decreased (MD = -1.37, 95%CI = -1.51 to-1.23, P < 0.000 01) in the experimental group, being significantly improved after levosimendan therapy. The funnel map evaluation showed that there might be a certain bias in the publication of the literature. Conclusion Levosimendan can improve circulatory disorders and reduce the time of stay in ICU for septic patients, but can not reduce their mortality.
Résumé
Objective:To study the relations between the length and costs of hospitalization and the severe ad- verse drug events which took place in the gastroenterologic and pulmonary wards.Method:Pharmacists surveyed ADEs in- cluding their existence and preventability in the wards,and found out the quantity of excessive length and extra costs of hos- pitalization.Result:There were totally 20 identified severe ADEs in which 11 were preventable in the pulmonary wards during 8 months and in the gastroenterologic wards during 5 months.The mean attribute length of stay was 17.8 days and mean attribute extra cost of hospitalization was 16,869 yuan for each ADE.The mean attribute length of stay was 19.3 days and mean attribute extra cost of hospitalization was 12,578 yuan for each preventable ADE.Conclusion:The attribute length of stay and extra costs of hospitalization were substantial.Since many severe ADEs were preventable,the effective measure must be taken to decrease their incidence.