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Annals of Intensive Care
Fig. 1 | Annals of Intensive Care

Fig. 1

From: Trends in ICU mortality and underlying risk over three decades among mechanically ventilated patients. A group level analysis of cohorts from infection prevention studies

Fig. 1

Search method, screening criteria and resulting classification of eligible studies and subsequent decant of component groups. The four numbered arrows are as follows; (1) An electronic search for systematic reviews containing potentially eligible studies using search terms; “ventilator associated pneumonia prevention”, “mechanical ventilation”, “intensive care unit”, each combined with either “meta-analysis” or “systematic review” up to December 2021 within The Cochrane database of systematic reviews. The systematic reviews were streamed into one of three categories; studies in which there was no intervention (observational studies), studies of various non-decontamination methods such as methods delivered either via the gastric route, the airway route or via the oral care route, studies of decontamination methods including studies with either an anti-septic or topical antibiotic (in any formulation)-based intervention. (2) The systematic reviews and meta-analyses were then searched for studies meeting the following inclusion criteria; (1) patient populations requiring prolonged (> 24 h) ICU admission; > (2) 50% of patients receiving mechanical ventilation for > 24 h; (3) mortality data available. (4) APACHE II score data available. And exclusion criteria; (1) Studies limited to paediatric ICU’s [mean age < 18 years]. (2) Studies limited to populations of ARDS patients (3) Studies limited to populations of Cardiac surgery patients. (3) Any duplicate or ineligible studies were removed and studies identified outside of systematic reviews, obtained by ‘snow ball sampling using the ‘related studies’ function in Google Scholar, were included. (4) The component groups were decanted from each study being control (rectangles), intervention (ovals) and observation (diamond) groups. NCC = non-concurrent control; CC = concurrent control. The total numbers do not tally as some systematic reviews provided studies in more than one category and some studies provided groups in more than one category. Also, some studies contribute both ICU and late mortality data

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