Table 2.
Mortality effect size estimates derived from RCCT array
| Intervention | ES | 95% CI | n | Source (references, page numbers, listed in data supplement) |
| UGIT interventions | ||||
| Any versus UC | 1.1 | 0.9 to 1.34 | 19 | (s210 p402) |
| 1.1 | 0.87 to 1.4 | 28 | Online supplemental figure S8 | |
| H2RA versus PPI | 0.96 | 0.78 to 1.19 | 12 | (s210 p441) |
| 0.91 | 0.66 to 1.27 | 12 | Online supplemental figure S9 | |
| H2RA versus antacids | 1.01 | 0.66 to 1.55 | 11 | (s210 p452) |
| 0.98 | 0.62 to 1.53 | 12 | Online supplemental figure S10 | |
| H2RA versus sucralfate | 1.1 | 0.95 to 1.24 | 21 | (s210 p459) |
| 1.12 | 0.95 to 1.33 | 22 | Online supplemental figure S11 | |
| Antacids versus sucralfate | 1.15 | 0.93 to 1.4 | 11 | (s210 p479) |
| 1.13 | 0.87 to 1.45 | 14 | Online supplemental figure S12 | |
| Other versus other | NR | |||
| 0.97 | 0.7 to 1.14 | 16 | Online supplemental figure S13 | |
| Aggregate | 1.05 | 0.95 to 1.16 | 103 | |
| Feeding interventions | ||||
| EN versus PN | 1.19 | 0.8 to 1.77 | 6 | (s211 p91) |
| 1.01 | 0.87 to 1.18 | 16 | Online supplemental figure S14 | |
| EN versus EN+PN | 0.99 | 0.84 to 1.16 | 5 | (s211 p98) |
| 1.8 | 0.92 to 3.5 | 4 | Online supplemental figure S15 | |
| EN versus delayed EN | 1.0 | 0.16 to 6.4 | 1 | (s212 p48) |
| 0.74 | 0.40 to 1.38 | 7 | Online supplemental figure S16 | |
| PP versus gastric | 1.03 | 0.83 to 1.29 | 11 | (s213 p50) |
| 1.06 | 0.77 to 1.46 | 11 | Online supplemental figure S17 | |
| Aggregate | 1.05 | 0.92 to 1.19 | 35 | |
| Airway interventions | ||||
| CTSS versus OTSS | 1.02 | 0.84 to 1.23 | 5 | (s214 p27) |
| 1.04 | 0.78 to 1.38 | 5 | Online supplemental figure S18 | |
| HH versus HME | 1.03 | 0.89 to 1.2 | 12 | (s215 p63) |
| 1.05 | 0.86 to 1.30 | 12 | Online supplemental figure S19 | |
| semirecumbent versus supine | NR | (s216) | ||
| 0.95 | 0.75 to 1.21 | 9 | Online supplemental figure S20 | |
| Silver ETT | 1.09 | 0.93 to 1.29 | 1 | (s217 p22) |
| 1.13 | 0.9 to 1.42 | 1 | Online supplemental figure S20 | |
| Aggregate | 1.03 | 0.91 to 1.17 | 26 | |
| Probiotic interventions | ||||
| 0.84 | 0.58 to 1.22 | 5 | (s218 p30) | |
| 0.81 | 0.62 to 1.06 | 9 | Online supplemental figure S21 | |
| Intervention | ES | 95% CI | n | source(ref & page number) |
| Oral care interventions | ||||
| Chlorhexidine versus UC | 1.09 | 0.96 to 1.23 | 14 | (s219 & s220) |
| 1.13 | 0.93 to 1.38 | 12 | Online supplemental figure S22 & S25 | |
| Toothbrushing | 0.84 | 0.67 to 1.05 | 5 | (s219 & s220) |
| 0.78 | 0.58 to 1.06 | 5 | Online supplemental figure S23 & S25 | |
| Other versus other | ||||
| 0.79 | 0.50 to 1.24 | 10 | Online supplemental figure S24 & S25 | |
| Aggregate | 0.97 | 0.83 to 1.14 | 33 | |
| Antibiotic interventions | ||||
| TAP+PPAP versus UC | 0.75 | 0.65 to 0.87 | 17 | (s221 p53) |
| 0.84 | 0.73 to 0.96 | 18 | (s222 p94) | |
| 0.77 | 0.66 to 0.91 | 19 | Online supplemental figure S25S26 & S29 | |
| TAP versus UC | 0.97 | 0.79 to 1.2 | 13 | (s221 p53) |
| 0.97 | 0.87 to 1.07 | 15 | (s222 p97) | |
| 0.99 | 0.78 to 1.26 | 15 | Online supplemental figure S26S27 & S29 | |
| TAP+PPAP versus PPAP(=duplex)* | 0.98 | 0.73 to 1.32 | 7 | (s221 p53) |
| 0.92 | 0.72 to 1.18 | 7 | (s222 p98) | |
| 0.91 | 0.66 to 1.26 | 7 | Online supplemental figure S27S28 & S29 | |
| Aggregate | 0.86; | 0.78 to 0.96 | 42 |
Source is either Cochrane review or online supplemental figures in this supplement.
The effect size estimates derived here are all ORs although in the source documents (210–222) these estimates are variously ORs or RRs. Those in bold achieved statistical significance.
The number of studies here differs from the equivalent in the Cochrane reviews as only those studies with mortality data in addition to pneumonia data have been included. The number of studies included in the generation of mortality effect sizes includes those reporting either or both of ICU and late mortality data towards generation of a single mortality effect size.
Duplex studies of antibiotic interventions were those in which the control group received PPAP.
Effect sizes significantly difference from null in bold.
Abbreviations; ICU is Intensive Care Unit, UC is Usual Care, H2RA is Histamine 2 receptor antagonists, PPI is Proton Pump Inhibitors, EN is Enteral nutrition, PN is Parenteral Nutrition, CTSS is Closed Tracheal Secretion Suction, OTSS is Open Tracheal Secretion Suction, HH is Heated Humidification, HME is Heat & Moisture Exchange, ETT is Endotracheal Tube.
*Duplex study is one where the study protocol provides PPAP to control group patients while providing both PPAP and TAP to intervention group patients.
CTSS, Closed Tracheal Secretion Suction; EN, Enteral nutrition; ES, effect size; ETT, Endotracheal Tube; HH, Heated Humidification; HME, Heat & Moisture Exchange; H2RA, Histamine 2 receptor antagonists; ICU, Intensive Care Unit; n, number of studies; NR, not reported; OTSS, Open Tracheal Secretion Suction; PN, Parenteral Nutrition; PPAP, protocolised parenteral antibiotic prophylaxis; PPI, Proton Pump Inhibitors; RR, risk ratio; TAP, topical antibiotic prophylaxis; UC, Usual Care; UGIT, upper gastrointestinal tract.