title: Impact of cytomegalovirus reactivation on clinical outcomes in immunocompetent critically ill patients: protocol for a systematic review and meta-analysis.
abstract: Cytomegalovirus (CMV) reactivation in critically ill patients is a well-recognized phenomenon with an incidence as high as 71 %. A number of studies have investigated the association between CMV reactivation and outcomes in critically ill patients with conflicting results. We propose to conduct a systematic review and meta-analysis to determine the impact of CMV reactivation on patient-centered outcomes and measures of health resource utilization in immunocompetent critically ill patients.
  
  
  
  In consultation with a research librarian, a search strategy will be developed and electronic databases (i.e., Ovid MEDLINE, Ovid EMBASE, and the Cochrane Library including the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials (CENTRAL)) will be searched for original studies. Selected grey literature sources will be hand-searched. Search themes will include cytomegalovirus, intensive care unit, and sepsis. Citation screening, selection, quality assessment, and data abstraction will be performed in duplicate. Pooled effect estimates of the impact of CMV reactivation on selected patient-centered outcomes and measures of health resource utilization will be described.
  
  
  
  This systematic review aims to explore the impact of CMV reactivation on patient-centered outcomes and health resource utilization in immunocompetent critically ill patients. Our results will help to better define the burden of disease associated with CMV reactivation. Indeed, evidence to date suggests increased mortality in this patient population. However, the relationship between CMV reactivation and health resource utilization remains less clear. Based on our results, future study on the impact of CMV treatment or prophylaxis on outcomes (including those other than mortality) may be warranted.
  
  
  
  PROSPERO CRD42016035446.
authors.affiliation: Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 2-124 Clinical Sciences Building, 8440 - 112th Street, Edmonton, Alberta, T6G 2B7, Canada. plachanc@ualberta.ca.
authors.forename: Philippe
authors.identifier: 0000-0002-5886-9951
authors.initials: P
authors.lastname: Lachance
authors.affiliation: Division of Infectious Diseases, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
authors.forename: Justin
authors.initials: J
authors.lastname: Chen
authors.affiliation: Alberta Research Centre for Health Evidence (ARCHE), Department of Pediatrics, University of Alberta, Edmonton, Canada.
authors.forename: Robin
authors.initials: R
authors.lastname: Featherstone
authors.affiliation: Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 2-124 Clinical Sciences Building, 8440 - 112th Street, Edmonton, Alberta, T6G 2B7, Canada.|Division of Infectious Diseases, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
authors.forename: Wendy
authors.initials: W
authors.lastname: Sligl
mesh_terms: D002985:Clinical Protocols; D016638:Critical Illness / Q000401:mortality*; D003587:Cytomegalovirus / Q000276:immunology* / Q000472:pathogenicity*; D003586:Cytomegalovirus Infections / Q000276:immunology* / Q000401:mortality; D006801:Humans; D007121:Immunocompetence / Q000276:immunology*; D015994:Incidence; D007362:Intensive Care Units; D000078202:Systematic Reviews as Topic; D019562:Viral Load; D014775:Virus Activation / Q000276:immunology* / Q000502:physiology; D015201:Meta-Analysis as Topic
keywords: Cytomegalovirus; Intensive care unit; Meta-analysis; Protocol; Systematic review