PT -期刊文章盟Medrinal克莱门特盟- Combret, Yann AU - Hilfiker, Roger AU - Prieur, Guillaume AU - Aroichane, Nadine AU - Gravier, Francis-Edouard AU - Bonnevie, Tristan AU - Contal, Olivier AU - Lamia, Bouchra TI - ICU outcomes can be predicted by noninvasive muscle evaluation: a meta-analysis AID - 10.1183/13993003.02482-2019 DP - 2020 Oct 01 TA - European Respiratory Journal PG - 1902482 VI - 56 IP - 4 4099 - //www.qdcxjkg.com/content/56/4/1902482.short 4100 - //www.qdcxjkg.com/content/56/4/1902482.full SO - Eur Respir J2020 Oct 01; 56 AB - Background The relationship between muscle function in critically ill patients assessed using bedside techniques and clinical outcomes has not been systematically described. We aimed to evaluate the association between muscle weakness assessed by bedside evaluation and mortality or weaning from mechanical ventilation, and the capacity of each evaluation tool to predict outcomes.Methods Five databases (PubMed, Embase, CINAHL, Cochrane Library, Science Direct) were searched from January 2000 to December 2018. Data were extracted and random effects meta-analyses were performed.Results 60 studies were analysed, including 4382 patients. Intensive care unit (ICU)-related muscle weakness was associated with an increase in overall mortality with odds ratios ranging from 1.2 (95% CI 0.60–2.40) to 4.48 (95% CI 1.49–13.42). Transdiaphragmatic twitch pressure had the highest predictive capacity for overall mortality, with a sensitivity of 0.87 (95% CI 0.76–0.93) and a specificity of 0.36 (95% CI 0.27–0.43). The area under the curve (AUC) was 0.74 (95% CI 0.70–0.78). Muscle weakness was associated with an increase in mechanical ventilation weaning failure rate with an odds ratio ranging from 2.64 (95% CI 0.72–9.64) to 19.07 (95% CI 9.35–38.9). Diaphragm thickening fraction had the highest predictive capacity for weaning failure with a sensitivity of 0.76 (95% CI 0.67–0.83) and a specificity of 0.86 (95% CI 0.78–0.92). The AUC was 0.86 (95% CI 0.83–0.89).Conclusion ICU-related muscle weakness detected by bedside techniques is a serious issue associated with a high risk of death or prolonged mechanical ventilation. Evaluating diaphragm function should be a clinical priority in the ICU.Tools that evaluated diaphragm function were better at predicting mortality in ICU or weaning failure https://bit.ly/2VHC0WH