PDF(Pubmed)
Abstract：
BACKGROUND: Dynamic arterial elastance (Eadyn) has been investigated for its ability to predict hypotension during the weaning of vasopressors. Our study focused on assessing Eadyn\'s performance in the context of critically ill adult patients admitted to the intensive care unit, regardless of diagnosis.
METHODS: Our study was conducted in accordance with the Preferred Reported Items for Systematic Reviews and Meta-Analysis checklist. The protocol was registered in PROSPERO (CRD42023421462) on May 26, 2023. We included prospective observational studies from the MEDLINE and Embase databases through May 2023. Five studies involving 183 patients were included in the quantitative analysis. We extracted data related to patient clinical characteristics, and information about Eadyn measurement methods, results, and norepinephrine dose. Most patients (76%) were diagnosed with septic shock, while the remaining patients required norepinephrine for other reasons. The average pressure responsiveness rate was 36.20%. The synthesized results yielded an area under the curve of 0.85, with a sensitivity of 0.87 (95% CI 0.74-0.93), specificity of 0.76 (95% CI 0.68-0.83), and diagnostic odds ratio of 19.07 (95% CI 8.47-42.92). Subgroup analyses indicated no variations in the Eadyn based on norepinephrine dosage, the Eadyn measurement device, or the Eadyn diagnostic cutoff to predict cessation of vasopressor support.
CONCLUSIONS: Eadyn, evaluated through subgroup analyses, demonstrated good predictive ability for the discontinuation of vasopressor support in critically ill patients.
METHODS: Our study was conducted in accordance with the Preferred Reported Items for Systematic Reviews and Meta-Analysis checklist. The protocol was registered in PROSPERO (CRD42023421462) on May 26, 2023. We included prospective observational studies from the MEDLINE and Embase databases through May 2023. Five studies involving 183 patients were included in the quantitative analysis. We extracted data related to patient clinical characteristics, and information about Eadyn measurement methods, results, and norepinephrine dose. Most patients (76%) were diagnosed with septic shock, while the remaining patients required norepinephrine for other reasons. The average pressure responsiveness rate was 36.20%. The synthesized results yielded an area under the curve of 0.85, with a sensitivity of 0.87 (95% CI 0.74-0.93), specificity of 0.76 (95% CI 0.68-0.83), and diagnostic odds ratio of 19.07 (95% CI 8.47-42.92). Subgroup analyses indicated no variations in the Eadyn based on norepinephrine dosage, the Eadyn measurement device, or the Eadyn diagnostic cutoff to predict cessation of vasopressor support.
CONCLUSIONS: Eadyn, evaluated through subgroup analyses, demonstrated good predictive ability for the discontinuation of vasopressor support in critically ill patients.
摘要：
背景：已经研究了动态动脉弹性（Eadyn）在降压药断奶期间预测低血压的能力。我们的研究重点是评估Eadyn在重症监护病房的危重成年患者中的表现，不管诊断。
方法：我们的研究是根据系统评价和荟萃分析检查表的首选报告项目进行的。该协议于2023年5月26日在PROSPERO（CRD42023421462）中注册。我们纳入了MEDLINE和Embase数据库的前瞻性观察研究，直至2023年5月。在定量分析中纳入了5项涉及183名患者的研究。我们提取了与患者临床特征相关的数据，以及有关Eadyn测量方法的信息，结果，和去甲肾上腺素剂量.大多数患者（76％）被诊断为感染性休克，而其余患者因其他原因需要去甲肾上腺素。平均压力反应率为36.20%。合成结果的曲线下面积为0.85，灵敏度为0.87（95％CI0.74-0.93），特异性为0.76（95%CI0.68-0.83），诊断比值比为19.07（95%CI8.47-42.92）。亚组分析表明，根据去甲肾上腺素剂量，Eadyn没有变化，Eadyn测量装置,或Eadyn诊断临界值来预测血管加压药支持的停止。
结论：Eadyn，通过亚组分析进行评估，对危重病患者停止血管加压药支持表现出良好的预测能力。
方法：我们的研究是根据系统评价和荟萃分析检查表的首选报告项目进行的。该协议于2023年5月26日在PROSPERO（CRD42023421462）中注册。我们纳入了MEDLINE和Embase数据库的前瞻性观察研究，直至2023年5月。在定量分析中纳入了5项涉及183名患者的研究。我们提取了与患者临床特征相关的数据，以及有关Eadyn测量方法的信息，结果，和去甲肾上腺素剂量.大多数患者（76％）被诊断为感染性休克，而其余患者因其他原因需要去甲肾上腺素。平均压力反应率为36.20%。合成结果的曲线下面积为0.85，灵敏度为0.87（95％CI0.74-0.93），特异性为0.76（95%CI0.68-0.83），诊断比值比为19.07（95%CI8.47-42.92）。亚组分析表明，根据去甲肾上腺素剂量，Eadyn没有变化，Eadyn测量装置,或Eadyn诊断临界值来预测血管加压药支持的停止。
结论：Eadyn，通过亚组分析进行评估，对危重病患者停止血管加压药支持表现出良好的预测能力。
