Diaphragm dysfunction and weaning failure in the ventilated critically ill patient: A systematic review and meta-analysis.
Introduction: Diaphragm dysfunction following mechanical ventilation is associated with weaning failure from the ventilator in critically ill patients, resulting in a bad prognosis and increased mortality. We conducted a systematic review and meta-analysis to measure the risk of diaphragm dysfunctio...
| Publicado en: | Critical Care & Shock Vol. 25; no. 3; pp. 109 - 123 |
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| Autores principales: | , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Critical Care & Shock Journal
2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=157181251&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 157181251 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14107767 6CKO jtl: Critical Care & Shock issn: 14107767 maglogo: N pubinfo: dt: 2022 vid: 25 iid: 3 pid: 45459 pub: Critical Care & Shock Journal place: Houston, Texas artinfo: ui: 157181251 157181251 157181251 157181251 ppf: 109 ppct: 14 formats: fmt: @attributes: type: P tig: atl: Diaphragm dysfunction and weaning failure in the ventilated critically ill patient: A systematic review and meta-analysis. aug: au: Putra Sitepu, Darma Yohanes Wolter Hendrik George, Dewi Larasatii Soedono, Rudyanto affil: Department of Anesthesiology and Intensive Care, Faculty of Medicine - Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia sug: subj: Diaphragm Pathology Ventilator Weaning Treatment Failure Critically Ill Patients Risk Assessment Human Systematic Review Meta Analysis PubMed Embase Cochrane Library Respiration, Artificial Outcome Assessment Quality Assessment Descriptive Statistics ab: Introduction: Diaphragm dysfunction following mechanical ventilation is associated with weaning failure from the ventilator in critically ill patients, resulting in a bad prognosis and increased mortality. We conducted a systematic review and meta-analysis to measure the risk of diaphragm dysfunction on weaning failure. Methods: We searched Pubmed, Embase, Cochrane, and Scopus databases without restriction to publication date. The clinical question was "is diaphragm dysfunction associated with weaning failure and increased weaning time in patients with >24 hours positive pressure mechanical ventilation?" The primary outcome was weaning failure, and the secondary outcome was weaning time. Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) was used to assess study quality and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach was used to assess the certainty of evidence. Results: The search string yielded 164 studies. Twenty-one studies were collected for full text and appraised thoroughly following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Four studies with similar clinical questions were included in the systematic review. ROBINS-I showed that the studies have a low to medium risk of bias. GRADE showed a moderate to a high level of certainty evidence. Pooled odds ratio (OR) showed diaphragm dysfunction was closely associated with weaning failure (156 patients), OR 3.27 (CI95% 1.34-8.02) but loosely associated with weaning time (188 patients), mean weaning time difference of 3.12 (CI95% - 0.09-6.33) hours. Conclusion: Diaphragm dysfunction as a complication of mechanical ventilation should be addressed carefully in critically ill patients since it is associated with weaning failure. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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