脑钠肽水平升高与撤机失败的相关性：系统评价和荟萃分析。

Association between elevated brain natriuretic peptide levels and weaning failure: A systematic review and meta-analysis.

机构信息

Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Int J Clin Pract. 2021 Nov;75(11):e14850. doi: 10.1111/ijcp.14850. Epub 2021 Sep 17.

DOI:10.1111/ijcp.14850

PMID:34516015

Abstract

OBJECTIVE

Cardiovascular dysfunction has been reported as an important mechanism of weaning failure, and recent data suggest that elevated brain natriuretic peptide (BNP) levels is associated with an increased risk of weaning failure. Therefore, we performed this meta-analysis to evaluate the correlation between elevated BNP levels and weaning failure in critically ill patients subject to mechanical ventilation.

METHODS

A systematic search in Cochrane Library, Embase, PubMed and Web of Science was performed up to September 25, 2019. Standard mean differences (SMD) and corresponding 95% confidence intervals (CIs) of the BNP levels were calculated for each study.

RESULTS

Nine studies with a total number of 589 were included in the final meta-analysis. The results showed that elevated BNP levels were significantly associated with the risk of weaning failure (SMD: 0.76, 95% CI: 0.47 to 1.05, P < .00001). The finding was consistent with the BNP measured before (SMD: 0.68, 95% CI: 0.26 to 1.11, P = .002) or at the end of spontaneous breathing trial (SBT) (SMD: 0.85, 95% CI: 0.52 to 1.18, P < .00001).

CONCLUSIONS

This meta-analysis showed that increased plasma BNP concentration was associated with weaning failure in ICU patients.

摘要

目的

心血管功能障碍已被报道为脱机失败的重要机制，最近的数据表明，脑利钠肽（BNP）水平升高与脱机失败的风险增加相关。因此，我们进行了这项荟萃分析，以评估机械通气的危重症患者中升高的 BNP 水平与脱机失败之间的相关性。

方法

系统检索 Cochrane Library、Embase、PubMed 和 Web of Science，检索时间截至 2019 年 9 月 25 日。计算每个研究中 BNP 水平的标准均数差值（SMD）和相应的 95%置信区间（CI）。

结果

最终荟萃分析纳入了 9 项研究，共 589 例患者。结果表明，升高的 BNP 水平与脱机失败的风险显著相关（SMD：0.76，95%CI：0.47 至 1.05，P<.00001）。这一发现与在自主呼吸试验（SBT）前（SMD：0.68，95%CI：0.26 至 1.11，P=.002）或结束时测量的 BNP（SMD：0.85，95%CI：0.52 至 1.18，P<.00001）一致。