Evidence mapPaperPMID 34782003Full record

SynthesisCritical care (London, England)2021

Prediction of extubation outcome in critically ill patients: a systematic review and meta-analysis.

Flavia Torrini, Ségolène Gendreau, Johanna Morel, Guillaume Carteaux, Arnaud W Thille, Massimo Antonelli, Armand Mekontso Dessap

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 3 pooled it
12.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

69 citing papers in PubMed, 3 syntheses or guidelines pooled it, 141 citations in OpenAlex.

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9 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 2 countries.

Flavia Torrini *Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, AP-HP, 1 rue Gustave Eiffel, 94010, Créteil Cedex, France.
Ségolène Gendreau *Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, AP-HP, 1 rue Gustave Eiffel, 94010, Créteil Cedex, France.ORCID http://orcid.org/0000-0002-8223-4411
Johanna MorelService de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, AP-HP, 1 rue Gustave Eiffel, 94010, Créteil Cedex, France.
Guillaume CarteauxService de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, AP-HP, 1 rue Gustave Eiffel, 94010, Créteil Cedex, France.
Arnaud W ThilleCentre d'Investigation Clinique 1402 ALIVE, Université de Poitiers, Poitiers, France.
Massimo AntonelliFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Armand Mekontso DessapService de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, AP-HP, 1 rue Gustave Eiffel, 94010, Créteil Cedex, France. armand.dessap@aphp.fr.
Université Paris-Est Créteil · FRInserm · FRAgostino Gemelli University Polyclinic · ITUniversité de Poitiers · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExtubation failure is an important issue in ventilated patients and its risk factors remain a matter of research. We conducted a systematic review and meta-analysis to explore factors associated with extubation failure in ventilated patients who passed a spontaneous breathing trial and underwent planned extubation. This systematic review was registered in PROPERO with the Registration ID CRD42019137003.

methodsWe searched the PubMed, Web of Science and Cochrane Controlled Register of Trials for studies published from January 1998 to December 2018. We included observational studies involving risk factors associated with extubation failure in adult intensive care unit patients who underwent invasive mechanical ventilation. Two authors independently extracted data and assessed the validity of included studies.

resultsSixty-seven studies (involving 26,847 participants) met the inclusion criteria and were included in our meta-analysis. We analyzed 49 variables and, among them, we identified 26 factors significantly associated with extubation failure. Risk factors were distributed into three domains (comorbidities, acute disease severity and characteristics at time of extubation) involving mainly three functions (circulatory, respiratory and neurological). Among these, the physiological respiratory characteristics at time of extubation were the most represented. The individual topic of secretion management was the one with the largest number of variables. By Bayesian multivariable meta-analysis, twelve factors were significantly associated with extubation failure: age, history of cardiac disease, history of respiratory disease, Simplified Acute Physiologic Score II score, pneumonia, duration of mechanical ventilation, heart rate, Rapid Shallow Breathing Index, negative inspiratory force, lower PaO

conclusionsNumerous factors are associated with extubation failure in critically ill patients who have passed a spontaneous breathing trial. Robust multiparametric clinical scores and/or artificial intelligence algorithms should be tested based on the selected independent variables in order to improve the prediction of extubation outcome in the clinical scenario.

Indexed as

Airway ExtubationCritical IllnessArtificial IntelligenceBayes TheoremHumansTreatment FailureAirway extubationRisk factorsVentilator weaning

Identifiers

PMID34782003
PMCPMC8591441
OpenAlexW3212630517

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.