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The Cochrane Libraryhttp://www.sris.com.tw
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Professor Archibald Leman Cochrane, CBE FRCP FFCM, (1909 - 1988)
Archie Cochrane Cochrane Collaboration 1972- Effectiveness and
Efficiency: Random Reflections on Health Services Randomised
Controlled Trials, RCTs
CBE )FRCP FFCM
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1972corticosteroid 1989 1991 30% 50%The Cochrane Collaboration
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(STRATEGY: top down)
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The Cochrane Library Cochrane Database of Systematic Reviews
(Cochrane Reviews) Impact Factor 2010= 6.186 (10/151 Medicine,
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evidence(Appraisal: VIP)Critically appraise the evidence(Apply: 3E)
Integrate with clinical expertise and patient values(Audit)
Monitoring your performance
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(Ask: PICO)Patient or Problem( )Intervention or Indicator()
Comparator() Outcome ()
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123
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80
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Does corticosteroid treatment in patients with septic shock
improve mortality?Question?
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Patient or PopulationPatient with septic shock (Intervention or
IndicatorCorticosteroid ComparatorNo corticosteroid
OutcomeMortalityPICO
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Septic shock ANDcorticosteroid ANDmortalityKey wards
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Advance search
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citation
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3541
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()
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Standard Full
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Topic: Corticosteroids for treating severe sepsis and septic
shock [review article] Djillali Annane, Eric Bellissant, Pierre
Edouard Bollaert, Josef Briegel, Didier Keh, Yizhak Kupfer January
2009Septic shock is the most severe form of infection. It may also
interfere with the production of corticosteroids, a a key hormone
for host defence against infection). This review showed that
overall corticosteroids did not impact on mortality. However, the
trials conducted after 1992 showed that long course ( 5 days) of
low dose of corticosteroids improved survival in septic shock
without causing harm. Trials performed before 1992 showed no
benefit from short course of high dose corticosteroids.Cochrane
library
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spesisseptic shock(corticotropin stimulation test)(a daily dose
of 200 to 300 mg of hydrocortisone (or equivalent) at least 5
days)
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Endnote
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MeSH search
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MeSH Search
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MeSH SearchNational Library of MedicineNLM1954Subject Heading
Authority List1960Index MedicusMedical Subject HeadingsM e S HM e S
HNLMNLMMEDLINE/PubMED
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MeSH SearchMedical Subject HeadingsM e S HSee:
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Case Study
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6-8?
6-8??
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Question?
Patient or PopulationAnesthesia, Spinal (Intervention or
IndicatorBed Rest ComparatorNo Bed Rest OutcomeHeadache
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Key Words Anesthesia, Spinal ANDbed rest ANDheadache
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Topic: Posture and fluids for preventing post-dural puncture
headache[review article] Cathie LM Sudlow,Charles P Warlow 21 JAN
2009To assess the effects on post dural puncture headache of a
period of bed rest versus early mobilisation, of different
positions during a period of bed rest, and of administering
supplementary fluids after the procedure. There is no good evidence
from randomised trials to suggest that routine bed rest after dural
puncture is beneficial. The role of fluid supplementation in the
prevention of post-dural puncture headache remains uncertain.
Cochrane library
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6-8~!6-8!
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You!
************PICOpatient,intervention,comparison,outcomesVIPvalidity,impact,practical
in
practice3Eevidence,expertise,expectation***********************(National
Health Research Institutes, Taiwan)2008The Cochrane
LibraryWiley-Blackwell
*******************Anesthesia, Conduction [+4] Anesthesia,
Epidural [+1] Anesthesia, Local Anesthesia, Spinal Nerve Block
[+1]
Anesthesia, Dental [+1] Anesthesia, General [+3] Anesthesia,
Intratracheal Anesthesia, Intravenous Anesthesia,
Obstetrical*****
