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

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...

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Detalles Bibliográficos
Publicado en:Critical Care Research & Practice pp. 1 - 6
Autores principales: Bandeira, Monique, Almeida, Alícia, Melo, Lívia, de Moura, Pedro Henrique, Ribeiro Silva, Emanuelle Olympia, Silva, Jakson, Dornelas de Andrade, Armèle, Brandão, Daniella, Campos, Shirley
Formato: review Journal Article
Publicado: Wiley-Blackwell 9/28/2021
Acceso en línea:Ver este registro en EBSCOhost
Descripción
Sumario: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.