Accuracy of Algorithms and Visual Inspection for Detection of Trigger Asynchrony in Critical Patients : A Systematic Review.

Autor: Bandeira M; Physical Therapy Department, Universidade Federal de Pernambuco, Recife, Brazil., Almeida A; Physical Therapy Department, Universidade Federal de Pernambuco, Recife, Brazil., Melo L; Hospital Geral Otavio de Freitas, Recife, Brazil., de Moura PH; Physical Therapy Department, Universidade Federal de Pernambuco, Recife, Brazil., Ribeiro Silva EO; Physical Therapy Department, Universidade Federal de Pernambuco, Recife, Brazil., Silva J; Physical Therapy Department, Universidade Federal de Pernambuco, Recife, Brazil., Dornelas de Andrade A; Physical Therapy Department, Universidade Federal de Pernambuco, Recife, Brazil., Brandão D; Physical Therapy Department, Universidade Federal de Pernambuco, Recife, Brazil., Campos S; Physical Therapy Department, Universidade Federal de Pernambuco, Recife, Brazil.
Jazyk: angličtina
Zdroj: Critical care research and practice [Crit Care Res Pract] 2021 Sep 28; Vol. 2021, pp. 6942497. Date of Electronic Publication: 2021 Sep 28 (Print Publication: 2021).
DOI: 10.1155/2021/6942497
Abstrakt: Objective: This study aimed to summarize the accuracy of the different methods for detecting trigger asynchrony at the bedside in mechanically ventilated patients.
Method: A systematic review was conducted from 1990 to 2020 in PubMed, Lilacs, Scopus, and ScienceDirect databases. The reference list of the identified studies, reviews, and meta-analyses was also manually searched for relevant studies. The reference standards were esophageal pressure catheter and/or electrical activity of the diaphragm. Studies were assessed following the QUADAS-2 recommendations, while the review was prepared according to the PRISMA criteria.
Results: One thousand one hundred and eleven studies were selected, and four were eligible for analysis. Esophageal pressure was the predominant reference standard, while visual inspection and algorithms/software comprised index tests. The trigger asynchrony, ineffective expiratory effort, double triggering, and reverse triggering were analyzed. Sensitivity and specificity ranged from 65.2% to 99% and 80% to 100%, respectively. Positive predictive values reached 80.3 to 100%, while the negative predictive values reached 92 to 100%. Accuracy could not be calculated for most studies.
Conclusion: Algorithms/software validated directly or indirectly using reference standards present high sensitivity and specificity, with a diagnostic power similar to visual inspection of experts.
Competing Interests: The authors have no conflicts of interest to declare.
(Copyright © 2021 Monique Bandeira et al.)
Databáze: MEDLINE
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