Automatic Tube Compensation During Spontaneous Breathing Trial.
BACKGROUND: Automatic tube compensation (ATC) is an option available in any ICU ventilator that compensates for the resistive pressure drop due to the endotracheal tube by providing flow assistance. The goal of the present study was to compare ATC to other patient triggered modes of support in terms...
| Publicado en: | Respiratory Care Vol. 67; no. 10; pp. 1335 - 1343 |
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| Autores principales: | , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Oct2022
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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=159224233&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 159224233 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Oct2022 vid: 67 iid: 10 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 159224233 159224233 159224233 10.4187/respcare.09920 159224233 ppf: 1335 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Automatic Tube Compensation During Spontaneous Breathing Trial. aug: au: Cardinal-Fernandez, Pablo Bougnaud, Joanna Cour, Martin Argaud, Laurent Poole, Daniele Guérin, Claude affil: Intensive Care Unit, HM Torrelodones Hospital, HM Group, Madrid, Spain sug: subj: Respiration, Artificial Airway Management Methods Ventilator Weaning Extubation Outcomes (Health Care) Human Systematic Review Meta Analysis PubMed Cochrane Library Confidence Intervals Data Analysis Software Descriptive Statistics ab: BACKGROUND: Automatic tube compensation (ATC) is an option available in any ICU ventilator that compensates for the resistive pressure drop due to the endotracheal tube by providing flow assistance. The goal of the present study was to compare ATC to other patient triggered modes of support in terms of spontaneous breathing trial (SBT) and extubation success. METHODS: Two authors (JB and PCF), independently and blinded to each other, searched through PubMed, Web of Science, and Cochrane from inception--May 26, 2021, with the following search terms entered as MeSH terms in all fields: "Automatic Tube Compensation." Inclusion criteria: randomized studies that included subjects > 16 y old undergoing an SBT. Exclusion criteria: crossover studies, pediatric studies, animal studies, or experimental studies on test lungs or on computer simulation; other languages than French, Spanish, or English; studies not published in a full-text format (eg, abstract or letter); and reviews. A frequentist network meta-analysis was conducted with the aim to investigate the effectiveness of ATC on SBT and extubation outcomes. SBT was defined as successful if patients could tolerate the SBT based on predetermined criteria, whether it was followed by extubation. Successful extubation was defined as the absence of re-intubation, noninvasive ventilation, or signs of respiratory distress within the 48 h after extubation. The pooled analyses used random-effect models, and the effect size was expressed as relative risk or mean difference for categorical and continuous variables, respectively. P-scores were used to rank all treatments and to identify the intervention with the highest probability of being the best. RESULTS: Of the 234 retrieved papers, 7 met the inclusion criteria. In terms of SBT success, ATC100+PEEP < 7.5 and PS10+PEEP < 7.5 were superior to T-piece. Likewise, PS10+PEEP < 7.5 was the intervention with the highest probability of being the best (P-score: 0.90). In terms of extubation success, ATC100+PEEP < 7.5 cm H2O was significantly better than PEEP < 7.5 and T-piece. Likewise, it had the highest probability of being the best (P-score= 0.90). CONCLUSIONS: ATC is the modality with the highest probability of being the best in terms of extubation success but not in terms of SBT success. 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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