Antioxidants For Sepsis: A Systematic Review And Meta-analysis

Objectives To assess the safety and the efficiency of antioxidants in patients with sepsis.Methods CBM database,Wanfang Database,CNKI database,VIP database,Medline database,Pubmed database,Science database,Embase database,Cochrane Library,Central database and foreign registration websites like www.chictr.org/cn,Clinical Trials.gov drug Clinical registration website were searched in the computer.Only Randomized Controlled trials(RCTS)were identified among the various types of studies.The study was conducted on adult sepsis patients regardless of race or gender.Patients in the experimental group were treated with traditional medical combination therapy and adjuvant therapy with commonly used clinical antioxidants,while patients in the control group were treated with a single traditional medical combination therapy.The main result is all-cause mortality.Secondary outcomes include the incidence of complications,the length of hospital stay,and the proportion of surgical needs.We worked out our review following the recommendations of the Cochrane handbook.We considered the methodological quality of the trial based on the 6 fields of the Cochrane Handbook and the Cochrane Hepatobiliary and Biliary Disease Group.Only trials that adequately describe all areas are assessed as having a low risk of bias.We measured the effect using risk ratio with 95%confidence interval.We use I-squared statistics to assess heterogeneity.For meta-analysis,we use a fixed-effect model and a random-effect model based on the I-squared statistic.Results Nine RCTS were included,including 13,752 subjects.Meta-analysis results suggested that adding antioxidants to traditional therapy could not reduce the mortality of patients[RR=0.94,95%CI(0.77,1.15)],and there was statistical heterogeneity among studies(I~2=75%,P=0.54).For other secondary indicators,antioxidants did not reduce the length of hospital stay in sepsis patients[MD=-0.70,95%CI(-1.80,0.40),P=0.21].SOFA score did not change significantly for patients[MD=0.15,95%CI(-0.12,0.41),P=0.28],Apacheⅱscore did not change significantly for the enrolled population[MD=-2.37,95%CI(-5.11,0.37),P=0.09].Antioxidant can reduce the duration of mechanical ventilation in patients with sepsis[MD=1.76,95%CI(1.14,2.38),P<0.00001].In addition,there are no side-effects caused by antioxidants reported in any of the included studies.Conclusions Traditional treatments combined with the antioxidants for the patients with sepsis can not reduce the mortality rate of patients with sepsis,the length of hospital stay and have no significant impact on the SOFA scores and ApacheⅡscores,but can reduce the duration of mechanical ventilation of patients.However,due to the risk bias in the included literature,the conclusions of this systematic evaluation need to be further confirmed.Figure 8;Table 4,Reference 154...