Readable, clinically-focused, actionable answers to inform point-of-care decision-making for health professionals.
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically-focused entry point to rigorous research from Cochrane Reviews. They are designed to be actionable and to inform point-of-care decision-making. Each CCA contains a clinical question, a short answer, and data for the outcomes from the Cochrane Review deemed most relevant to practising healthcare professionals. The evidence is displayed in a user-friendly tabulated format that includes narratives, data, and links to graphics.
CCAs are available with a Cochrane Library subscription or national license.
The following CCAs will be free until 31 March 2020:
- What are the effects of different types of psychological therapies on outcomes in both children with chronic illness and their parents?
- Can hypothermic machine perfusion increase success of deceased donor kidney transplantation compared with static cold storage?
- For women undergoing hysterectomy, how does robot-assisted surgery (RAS) compare with conventional laparoscopic surgery (CLS)?
- How does memantine compare with placebo for treating adults with moderate-to-severe Alzheimer’s disease?
- What are the effects of sumatriptan plus naproxen for adults with acute migraine attacks?
The following CCAs will be free until 30 April 2020:
- How does memantine compare with placebo for treating adults with mild Alzheimer’s disease?
- How does memantine compare with placebo for treating adults with mild-to-moderate vascular dementia?
- What are the effects of chlorhexidine bathing for preventing hospital-acquired infection in critically ill people?
- How does surgical removal compare with retention for management of asymptomatic disease-free impacted wisdom teeth?
The following CCAs are free as part of our Special Collection on the Coronavirus (COVID-19): evidence relevant to critical care:
Fluid and vasopressor therapy: Initial resuscitation for hypotension typically includes administration of intravenous fluids, followed by initiation of vasopressors when hypotension persists.
- For children with sepsis or septic shock, how does liberal fluid therapy compare with conservative fluid therapy?
- How do colloids compare with crystalloids for fluid resuscitation in critically ill people?
- How do buffered solutions compare with 0.9% saline for critically ill people requiring intravenous fluid therapy?
- How does norepinephrine compare with other vasopressors in people with hypotensive shock?
Respiratory support and mechanical ventilation: Patients with severe acute respiratory infection may require supplemental oxygen and mechanical ventilatory support.
- How does a high‐flow nasal cannula compare with low‐flow oxygen for adults in intensive care requiring respiratory support?
- What are the effects of recruitment maneuvers for adults with acute respiratory distress syndrome receiving mechanical ventilation?
- How does a semi‐recumbent position compare with a supine position in adults requiring mechanical ventilation?
- How do pressure and volume‐controlled ventilation compare in people with acute respiratory failure or distress syndrome?
- How does interruption of daily sedation compare with no interruption for critically ill adults requiring invasive mechanical ventilation?
Weaning mechanical ventilation: Reducing weaning time is desirable in minimizing potential complications from mechanical ventilation.
- How does protocolized compare with non‐protocolized weaning off mechanical ventilation for critically ill adults?
Managing hypoxaemia: Acute or chronic hypoxaemia is a common reason for admission to intensive care and for provision of mechanical ventilation. Various refinements of mechanical ventilation or adjuncts are employed to improve patient outcomes.
- For adults admitted to the intensive care unit (ICU), how do different oxygenation levels compare?
- How does prone positioning compare with supine positioning for ventilation in adults with severe acute respiratory failure?
Pharmacological treatment: Although fluid resuscitation and ventilatory support are the mainstays of treatment for patients with SARI requiring critical care, various pharmacological interventions have been suggested, yet the benefits and harms remain uncertain.
- What are the effects of pharmacological agents for adults with acute respiratory distress syndrome (ARDS)?
- For adults with influenza admitted to hospital, what are the effects of corticosteroids given to relieve symptoms associated with severe influenza?
- For adults with acute respiratory distress syndrome (ARDS) who are mechanically ventilated, how does immunonutrition compare with standard formula feeding?
- Which regimen is most effective at improving outcomes in critically ill adults with hospital‐acquired pneumonia: short‐course or prolonged‐course antibiotic therapy?
- In children admitted to hospital with community‐acquired pneumonia, how do different antibiotics compare with each other? And In children with community‐acquired pneumonia in the ambulatory setting, what are the effects of oral antibiotics?
- In hospitalized adults with community‐acquired pneumonia, is there randomized controlled trial evidence to support the use of empiric atypical antibiotic coverage over typical antibiotic coverage?
Managing delirium: Delirium is defined as a disturbance in attention, awareness, and cognition, with reduced ability to direct, focus, sustain, and shift attention, and reduced orientation to the environment.
- How does haloperidol compare with placebo for preventing delirium in critically ill adults in intensive care?
Nutrition in intensive care: Critically ill people are at increased risk of malnutrition. Acute and chronic illness, trauma and inflammation induce stress‐related catabolism, and drug‐induced adverse effects may reduce appetite or increase nausea and vomiting. In addition, patient management in the intensive care unit (ICU) may also interrupt feeding routines.
- How does enteral nutrition compare with parenteral nutrition (with or without enteral nutrition) for adults admitted to the intensive care unit (ICU)?
The following CCAs are free as part of our Special Collection on the Coronavirus (COVID-19): infection control and prevention measures
- Can physical interventions help reduce the spread of respiratory viruses?
- What are the effects of multimodal campaigns to improve hand hygiene of healthcare workers?
- What are the effects of performance feedback, education, and olfactory/visual cues on hand hygiene of healthcare workers?
- Does use of personal protective equipment (PPE), or interventions to increase PPE use by healthcare workers, reduce the spread of highly infectious diseases?
- Do gloves, gowns, and masks reduce transmission of MRSA in the hospital setting?
- What are the effects of chlorhexidine bathing for preventing hospital‐acquired infection in people admitted to intensive care units (ICUs)?
Get involved: The clinical answer is written either by a practicing clinician or by a CCA Editor, with the answer being peer-reviewed by a practicing clinician. If you would like to join the Clinical Answers authoring team, please contact the team at firstname.lastname@example.org. We are specifically looking for clinicians in the following areas: respiratory medicine; care of the elderly; cardiovascular medicine; pregnancy and childbirth; neurology - especially epilepsy; infectious disease; paediatrics; rheumatology; ENT; and urology.