Spatulas for operative vaginal birth: A systematic review and meta‐analysis

Grillo‐Ardila, Carlos Fernando; Páez-Castellanos, Edgar; Bolaños-Palacios, Jesús Camilo; Bautista-Charry, Alejandro Antonio

doi:10.1002/ijgo.13681

Cited by 8 publications

(1 citation statement)

References 47 publications

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“…The protocol of this review was designed following the Cochrane Handbook recommendations [ 17 ] and the methodological guidance of the Cochrane Methods Group for Non-Randomized Studies for Interventions [ 18 , 19 ] and was registered in advance in Prospero on 7 July 2023 (CRD42023439265), following the PRISMA statement [ 20 ]. Because this study is a systematic review, no ethical approval was required.…”

Section: Methodsmentioning

confidence: 99%

Early Enteral Nutrition (within 48 h) for Patients with Sepsis or Septic Shock: A Systematic Review and Meta-Analysis

Grillo-Ardila,

Tibavizco-Palacios,

Triana

et al. 2024

Nutrients

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OBJECTIVE: Medical nutrition therapy provides the opportunity to compensate for muscle wasting and immune response activation during stress and trauma. The objective of this systematic review is to assess the safety and effectiveness of early enteral nutrition (EEN) in adults with sepsis or septic shock. METHODS: The MEDLINE, Embase, CENTRAL, CINAHL, ClinicalTrials.gov, and ICTRP tools were searched from inception until July 2023. Conference proceedings, the reference lists of included studies, and expert content were queried to identify additional publications. Two review authors completed the study selection, data extraction, and risk of bias assessment; disagreements were resolved through discussion. Inclusion criteria were randomized controlled trials (RCTs) and non-randomized studies (NRSs) comparing the administration of EEN with no or delayed enteral nutrition (DEE) in adult populations with sepsis or septic shock. RESULTS: Five RCTs (n = 442 participants) and ten NRSs (n = 3724 participants) were included. Low-certainty evidence from RCTs and NRSs suggests that patients receiving EEN could require fewer days of mechanical ventilation (MD −2.65; 95% CI, −4.44–0.86; and MD −2.94; 95% CI, −3.64–−2.23, respectively) and may show lower SOFA scores during follow-up (MD −1.64 points; 95% CI, −2.60–−0.68; and MD −1.08 points; 95% CI, −1.90–−0.26, respectively), albeit with an increased frequency of diarrhea episodes (OR 2.23, 95% CI 1.115–4.34). Even though the patients with EEN show a lower in-hospital mortality rate both in RCTs (OR 0.69; 95% CI, 0.39–1.23) and NRSs (OR 0.89; 95% CI, 0.69–1.13), this difference does not achieve statistical significance. There were no apparent differences for other outcomes. CONCLUSIONS: Low-quality evidence suggests that EEN may be a safe and effective intervention for the management of critically ill patients with sepsis or septic shock.

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Section: Methodsmentioning

confidence: 99%

Early Enteral Nutrition (within 48 h) for Patients with Sepsis or Septic Shock: A Systematic Review and Meta-Analysis

Grillo-Ardila,

Tibavizco-Palacios,

Triana

et al. 2024

Nutrients

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Which type of forceps is better for nonrotational operative births? A simulation study comparing Thierry spatulas and Simpson‐Braun and Kielland forceps

Cuerva,

Villasante,

Cruset

et al. 2024

Intl J Gynecology & Obste

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ObjectiveObstetric forceps play an important role in safe childbirth, yet there is a lack of distinction between various forceps types in clinical practice. This study aimed to evaluate and compare perineal pressure and forces on the baby during nonrotational forceps‐assisted births using Simpson‐Braun forceps, Kielland forceps, and Thierry spatulas on a simulation model.MethodsThis experimental study involved six obstetricians conducting 108 forceps‐assisted births on a simulation model. Instruments were assessed for their impact on perineal pressure, traction force, and operator‐assessed difficulty.ResultsThierry's spatulas exerted the lowest force on the baby, while Kielland forceps exhibited the lowest perineal pressure, though not statistically significant. An experienced obstetrician demonstrated less perineal pressure with Simpson forceps. Notably, no significant differences in difficulty were observed between instruments.ConclusionThis study highlights distinctions in forceps performance, with Thierry spatulas applying the least force on the fetal head, while an experienced obstetrician fared better with Simpson forceps in terms of perineal pressure. Kielland forceps remain a viable alternative for nonrotational forceps births, showing comparable outcomes.

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Obstetrics Forceps Delivery

Dutta

Rai

2023

Labour and Delivery

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Spatulas for operative vaginal birth: A systematic review and meta‐analysis

Cited by 8 publications

References 47 publications

Early Enteral Nutrition (within 48 h) for Patients with Sepsis or Septic Shock: A Systematic Review and Meta-Analysis

Early Enteral Nutrition (within 48 h) for Patients with Sepsis or Septic Shock: A Systematic Review and Meta-Analysis

Which type of forceps is better for nonrotational operative births? A simulation study comparing Thierry spatulas and Simpson‐Braun and Kielland forceps

Obstetrics Forceps Delivery

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