A Bayesian Network Meta-analysis Of Preventive Measures For Exposure Keratitis In Critically Ill Patient

ObjectiveBayesian network meta-analysis was used to analyze the preventive effect of various preventive measures on severe patients with exposure keratitis,and to rank the curative effects,in order to provide scientific theoretical basis for clinical nursing decisions.MethodsRandomized controlled trials(RCTS)on the prevention of exposure keratitis in critically ill patients in Pubmed,Cochrane,EMBASE,Web of Science,CINAHL,Chinese journal full-text database,wan fang database,Chinese journal of Science and technology database,and Chinese biomedical literature service system were searched.In this study,the incidence of EK was the main outcome index,and the incidence of corneal infection and keratopathy score were the secondary outcome indexes.Cochrane handbook(5.0.1)was used to evaluate the quality of included studies.Reveman5.3 and Stata15.0 were used for plotting,R3.2.5 was used to call "gemtc-0.8.2" software package and "rags-4.1.0" software package for bayesian network meta-analysis,and gemtc-0.14.3 software was used for quantitative evaluation of the model's fitting degree,to evaluate the consistency of bayesian network meta-analysis results,and to perform frequency network meta-analysis with Stata15.0 to evaluate the sensitivity of the study,in addition,funnel plots are drawn to detect the publication deviation.ResultsA total of 16 studies,including 11 preventive measures,were included in a total of 1387 patients.In terms of the effect of preventing the occurrence of EK in critically ill patients:(1)aseptic polyethylene film,lubricating ointment + aseptic polyethylene film,lubricating ointment,hydrocolloid dressing,antibiotic ointment + aseptic polyethylene film and lubricating ointment +adhesive tape showed no statistical difference in the preventive effect of these 6 preventive measures.Its preventive effect is better than antibiotic eye cream,antibiotic eye drops + antibiotic eye cream;(2)Vitamin A eye ointment,A traditional wet room,sterile polyethylene film,lubrication oculentum + sterile polyethylene film,lubrication eye ointment,hydrocolloid dressings,and antibiotic oculentum + sterile polyethylene film,the protective effect of seven kindsof measures of difference is not significant,the protective effect of vitamin A eye ointment and the traditional wet room were superior to artificial tears,antibiotic eye ointment,antibiotics eye drops and eye ointment;(3)There was no statistical difference in the prevention effect of artificial tears and antibiotic eye cream,artificial tears and antibiotic eye drops + antibiotic eye cream on EK in severe patients;(4)The prevention effect of antibiotic eye ointment on EK in critically ill patients is better than that of antibiotic eye drops + antibiotic eye ointment.11 kinds of preventive measures in critically ill patients with EK the preventive effect of sorting by superior to inferior to:vitamin A eye ointment,A traditional wet room,sterile polyethylene film,lubrication oculentum +sterile polyethylene film,lubrication eye ointment,hydrocolloid dressings,antibiotic oculentum +sterile polyethylene film,lubrication ointment + tape,artificial tears,antibiotic eye ointment,antibiotics eye drops +eye ointment.In the aspect of prevention of critically ill patients with mechanical ventilation EK: the effect of vitamin A eye ointment,sterile polyethylene film,lubrication ointment + sterile polyethylene film,lubrication eye ointment,hydrocolloid dressings,lubrication ointment + tape the six measures to the prevention effect of the difference have no sense of statistics,vitamin A ointment most likely be the best preventive measures.In the prevention of corneal infection in patients with severe mechanical ventilation:there was no statistically significant difference between sterile polyethylene film,lubricating eye ointment and vitamin A eye ointment,among which vitamin A eye ointment had the highest probability as the best measure to prevent corneal infection.The four measures of sterile polyethylene film,hydrocolloid dressing,lubricating eye ointment and vitamin A eye ointment were evaluated from the degree of keratopathy.There was no statistically significant difference among the four measures,but the probability of vitamin A eye ointment being the best preventive measure for EK prevention in patients with severe mechanical ventilation was the highest.ConclusionOnly through the analysis of the bayesian network Meta RCT,in terms of the prevention effect of EK in severe patients,vitamin A eye ointment,traditional wet room,aseptic polyethylene film,lubricating ointment + aseptic polyethylene film,lubricating ointment,hydrocolloid dressing,antibiotic eye ointment + aseptic polyethylene film,lubricating ointment + adhesive tape are currently better preventive measures for the prevention of EK in severe patients,artificial tears,antibiotic eye cream,antibiotic eye drops + antibiotic eye cream's prevention effect is poor.In the prevention of EK in critically ill patients with mechanical ventilation,vitamin A eye ointment,aseptic polyethylene film,lubricating ointment + aseptic polyethylene film,lubricating ointment,hydrocolloid dressing,lubricating ointment + adhesive tape,these 6 measures did not show significant differences.Vitamin A eye ointment is the most likely to be the best preventive measure in the prevention of EK and corneal infection.However,due to the small number of studies included,this conclusion still needs to be further verified by more high-quality and large sample RCT experiments.