机械通风ICU患者的手握强度与断奶结果的关联:系统性审查和元分析
Henri De Noray1, Noémie C Duclos2,3, Alexandre Boyer4,5
1Centre Hospitalo-Universitaire de Bordeaux, pôle neurosciences cliniques, Bordeaux, France. henri.de-noray@chu-bordeaux.fr.
Critical care (London, England)
|November 7, 2025
概括
最大手握强度 (HGS) 并不能可靠地预测重症监护室 (ICU) 患者的输出成功. 虽然较低的HGS与自发呼吸试验失败有关,但它并不能显著区分输出管成功与失败.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统疗法 呼吸系统疗法
- 神经肌肉生理学 神经肌肉生理学
背景情况:
- 机械通风断奶在ICU中至关重要,输出失败与不良结果有关.
- 在ICU获得的软弱是长期断奶的已知风险因素.
- 最大手握强度 (HGS) 是一种简单的床边测试,用于评估总体肌肉强度.
研究的目的:
- 系统地审查和元分析最大HGS和机械通风ICU患者的断奶结果之间的关联.
- 评估HGS作为预测断奶成功或失败的潜在代孕标记.
主要方法:
- 在主要数据库 (MEDLINE,EMBASE,CINAHL,Cochrane) 进行系统的文献搜索,截至2024年12月.
- 包括前性队列研究,在成人ICU患者的输出前测量HGS.
- 使用层次概要ROC模型对结果组之间的HGS差异和诊断准确性的元分析.
主要成果:
- 包括七项研究 (707名患者),其中六项在分析中.
- 在输出失败和成功组之间没有观察到HGS的显著差异.
- 较低的HGS与自发呼吸试验 (SBT) 的失败和非简单的断奶结果有显著的关联.
结论:
- 最大HGS似乎不是输出成功和失败之间的显著差异.
- 虽然与SBT故障和非简单断奶有关,但HGS的预测值需要进一步调查.
- 需要高质量的研究来澄清HGS在不同患者子组和时间框架中的预后价值.
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