ICU outcomes can be predicted by noninvasive muscle evaluation: A meta-analysis
| Autor: | Medrinal, Clément, Combret, Yann, Hilfiker, Roger, Prieur, Guillaume, Aroichane, Nadine, Gravier, Francis Edouard, Bonnevie, Tristan, Contal, Olivier, Lamia, Bouchra, Ali, Naeem, Carrié, Cédric, Cottereau, Guillaume, Demoule, Alexandre, Dres, Martin, Dubé, Bruno Pierre, Goligher, Ewan, Hermans, Greet, Hussein, Aliae Mohamed, Spadaro, Savino, Tenza-Lozano, Eva María, Wieske, Luuk, Witteveen, Esther |
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| Přispěvatelé: | Neurology |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty medicine.medical_treatment Critical Illness Diaphragm Cochrane Library 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Weaning Humans Mechanical ventilation business.industry Area under the curve Muscle weakness 030208 emergency & critical care medicine Odds ratio Respiration Artificial Diaphragm (structural system) Intensive Care Units 030228 respiratory system Meta-analysis Cardiology medicine.symptom business Ventilator Weaning |
| Zdroj: | European respiratory journal, 56(4):1902482. European Respiratory Society |
| ISSN: | 0903-1936 |
| Popis: | BackgroundThe relationship between muscle function in critically ill patients assessed using bedside techniques and clinical outcomes has not been systematically described. We aimed to evaluate the association between muscle weakness assessed by bedside evaluation and mortality or weaning from mechanical ventilation, and the capacity of each evaluation tool to predict outcomes.MethodsFive databases (PubMed, Embase, CINAHL, Cochrane Library, Science Direct) were searched from January 2000 to December 2018. Data were extracted and random effects meta-analyses were performed.Results60 studies were analysed, including 4382 patients. Intensive care unit (ICU)-related muscle weakness was associated with an increase in overall mortality with odds ratios ranging from 1.2 (95% CI 0.60–2.40) to 4.48 (95% CI 1.49–13.42). Transdiaphragmatic twitch pressure had the highest predictive capacity for overall mortality, with a sensitivity of 0.87 (95% CI 0.76–0.93) and a specificity of 0.36 (95% CI 0.27–0.43). The area under the curve (AUC) was 0.74 (95% CI 0.70–0.78). Muscle weakness was associated with an increase in mechanical ventilation weaning failure rate with an odds ratio ranging from 2.64 (95% CI 0.72–9.64) to 19.07 (95% CI 9.35–38.9). Diaphragm thickening fraction had the highest predictive capacity for weaning failure with a sensitivity of 0.76 (95% CI 0.67–0.83) and a specificity of 0.86 (95% CI 0.78–0.92). The AUC was 0.86 (95% CI 0.83–0.89).ConclusionICU-related muscle weakness detected by bedside techniques is a serious issue associated with a high risk of death or prolonged mechanical ventilation. Evaluating diaphragm function should be a clinical priority in the ICU. |
| Databáze: | OpenAIRE |
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