BACKGROUND: We investigated whether resuscitation protocols to achieve and maintain urine output above a predefined threshold-including @entity1458 reversal as a target--prevent @entity810 ( @entity810 ). METHODS: We performed a systematic review and meta-analysis using studies found by searching MEDLINE, EMBASE, and references in relevant reviews and articles. We included all studies that compared "conventional fluid management" (CFM) with "goal-directed therapy" (GDT) using cardiac output, urine output, or @entity26 delivery parameters and reported the occurrence of @entity810 in critically ill or surgical @entity1 . We divided studies into groups with and without @entity1458 reversal as a target for hemodynamic optimization. We calculated the combined odds ratio (OR) and 95% confidence intervals (CIs) using random-effects meta-analysis. RESULTS: We based our analyses on 28 studies. In the overall analysis, GDT resulted in less @entity810 than CFM (OR, 0.58; 95% CI, 0.44-0.76; P < 0.001; I = 34.3%; n = 28). GDT without @entity1458 reversal as a target resulted in less @entity810 (OR, 0.45; 95% CI, 0.34-0.61; P < 0.001; I = 7.1%; n = 7) when compared with CFM with @entity1458 reversal as a target. The studies comparing GDT with CFM in which the reversal of @entity1458 was targeted in both or in neither group did not provide enough evidence to conclude a superiority of GDT (targeting @entity1458 reversal in both protocols: OR, 0.63; 95% CI, 0.36-1.10; P = 0.09; I = 48.6%; n = 9, and in neither protocol: OR, 0.66; 95% CI, 0.37-1.16; P = 0.14; I = 20.2%; n = 12). CONCLUSIONS: Current literature favors targeting circulatory optimization by GDT without targeting @entity1458 reversal to prevent @entity810 . Future studies are needed to investigate the hypothesis that targeting @entity1458 reversal does not prevent @entity810 in critically ill and surgical @entity1 .

Targeting Oliguria Reversal in Goal-Directed Hemodynamic Management Does Not Reduce Renal Dysfunction in Perioperative and Critically Ill XXXX : A Systematic Review and Meta-Analysis.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen'] @entity810 :: ('MESH:D058186', 'Disease') :: ['ARF', 'acute renal failure'] @entity1458 :: ('MESH:D009846', 'Disease') :: ['oliguria']
@entity1 :: (9606,Species) :: ['Patients']
