BACKGROUND AND PURPOSE: Intraventricular hemorrhage is associated with high mortality and poor functional outcome. The use of intraventricular fibrinolytic (IVF) therapy as an intervention in intraventricular hemorrhage is an evolving therapy with conflicting reports in the literature. The goal of this study is to investigate the impact of IVF on mortality, functional outcome, ventriculitis, shunt dependence, and rehemorrhage. METHODS: During March and April 2014, a systematic literature search was performed identifying 1359 articles. Of these, 24 met inclusion criteria. A random effects meta-analysis was performed using both pooled and subset analysis based on study type. RESULTS: Our meta-analysis demonstrated that IVF reduced mortality in intraventricular hemorrhage by nearly half (relative risk [RR], 0.55; 95% confidence interval [CI], 0.42-0.71; P<0.00001), increased the likelihood of good functional outcome by 66% (RR, 1.66; 95% CI, 1.27-2.19; P=0.0003), and also decreased the rate of shunt dependence (RR, 0.62; 95% CI, 0.42-0.93; P=0.02). IVF was not found to be associated with increased rates of ventriculitis (RR=1.46; 95% CI, 0.77-2.76; P=0.25) or rehemorrhage (RR=1.06; 95% CI, 0.66-1.70; P=0.80). We detected no evidence of publication bias. CONCLUSIONS: Our meta-analysis showed that IVF is safe and could be an effective strategy for the treatment of intraventricular hemorrhage. It may reduce mortality, improve functional outcome, and diminish the need for permanent ventricular shunting, while not increasing the risk of ventriculitis or rehemorrhage.

• MeSH
• cerebrální krvácení mortalita   terapie   MeSH
• klinické zkoušky jako téma MeSH
• lidé MeSH
• recidiva MeSH
• riziko MeSH
• trombolytická terapie metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH
• přehledy MeSH