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Fig. 5 | Critical Care

Fig. 5

From: Regional citrate versus heparin anticoagulation for continuous renal replacement therapy in critically ill patients: a meta-analysis with trial sequential analysis of randomized controlled trials

Fig. 5

Effect of regional citrate versus heparin anticoagulation on circuit life span (pre-dilution and post-dilution subgroup analysis). a Circuit life span. b-e Complete blue line represents the cumulative Z-curve, complete red line represents the trial sequential monitoring boundary for benefit and etched green line represents the conventional boundary for benefit. b The DerSimonian-Laird (DL) approach used for the pre-dilution subgroup (eight trials). A diversity-adjusted information size of 1355 circuits was calculated on the basis of a mean difference (MD) of 17.51, variance of 150.43, I 2 = 98.82 %, α = 5 % (two sided) and β = 20 %. The cumulative Z-curve crosses the trial sequential monitoring boundary for benefit and reaches the required information size. c The Sidik-Jonkman (SJ) approach used for the pre-dilution subgroup (six trials: two trials ignored in the interim looks due to too low information use (<1.0 %)). A diversity-adjusted information size of 7106 circuits was calculated on the basis of a MD of 18.55, variance of 150.43, I 2 = 99.8 %, α = 5 % (two sided) and β = 20 %. The cumulative Z-curve crosses the conventional boundary but not the trial sequential monitoring boundary. d The DL approach used for the post-dilution subgroup (three trials). A diversity-adjusted information size of 2232 circuits was calculated on the basis of a MD of 13.06, variance of 509.29, I 2 = 95.79 %, α = 5 % (two sided) and β = 20 %. The cumulative Z-curve does not cross the conventional boundary or trial sequential monitoring boundary. e The SJ approach used for the post-dilution subgroup (two trials: one trial ignored in the interim looks due to too low information use (<1.0 %)). A diversity-adjusted information size of 6516 circuits calculated on the basis of a MD of 15.76, variance of 509.29, I 2 = 99.0 %, α = 5 % (two sided) and β = 20 %. The cumulative Z-curve does not cross the conventional boundary or trial sequential monitoring boundary. AU Australia, DE Germany, CA, Canada, CN, China, NL The Netherlands, IV Inverse Variance

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