Predictive value of percent change in brain natriuretic peptide for endotracheal tube extubation in invasive mechanically ventilated patients during spontaneous breathing trial: a meta-analysis

doi:10.3877/cma.j.issn.1674-6880.2019.03.005

Abstract

Abstract:

Objective

To assess the predictive value of percent change in brain natriuretic peptide (BNP%) for endotracheal tube extubation in invasive mechanically ventilated patients during spontaneous breathing trial (SBT).

Methods

Searches were conducted in the PubMed, Embase, Medline, Ovid, Cochrane Central Register of Controlled Trails and Information Sciences Institute Web of Science for studies on the predictive value of BNP% for endotracheal tube extubation in invasive mechanically ventilated patients published up to March 31, 2018. The Quality Assessment of Diagnostic Accuracy Studies (Quasas-2) was used for quality assessment. The MetaDiSc was used for heterogeneity analysis, and the pooled diagnostic odds ratio (DOR), pooled sensitivity, pooled specificity, pooled positive likelihood ratio (PLR), pooled negative likelihood ratio (NLR), and the area under the summary receiver operating characteristic (SROC) curve were calculated.

Results

A total of 213 patients were recruited from 5 trials. Meta-analysis showed that the pooled DOR was 22.33 [95% confidence interval (CI) (9.25, 53.91)], the pooled sensitivity was 85% [95%CI (0.78, 0.91)], the pooled specificity was 80% [95%CI (0.68, 0.90)], the pooled PLR was 3.72 [95%CI (2.11, 6.55)], and the pooled NLR was 0.18 [95%CI (0.12, 0.28)]. The pooled DOR, sensitivity, specificity, PLR, and NLR showed no significant heterogeneity (all P > 0.1, all I² < 50%), and the area under the SROC curve was 0.913.

Conclusion

BNP% can elevate the predictive value for endotracheal tube extubation in invasive mechanically ventilated patients during SBT.

Key words: Brain natriuretic peptide, Ventilators, mechanical, Spontaneous breathing trial

Wei Cao, Xiu Wu, Bin Zhang, Shengyu Wang. Predictive value of percent change in brain natriuretic peptide for endotracheal tube extubation in invasive mechanically ventilated patients during spontaneous breathing trial: a meta-analysis[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2019, 12(03): 169-173.

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第一作者	国家	例数	性别比（例，男/女）	阈值（%）	AUC（95%CI）	真阳性值	假阳性值	真阴性值	假阴性值	敏感度（%）	特异度（%）
Farghaly^[2]	埃及	30	13/17	14.9	0.80（0.66，0.92）	13	5	9	3	81.25	65.00
Chien^[12]	中国	52	37/15	20.0	0.93（0.85，1.00）	37	1	10	4	91.00	88.00
Maraghi^[24]	埃及	40	26/14	20.0	0.96（-）	27	1	7	5	85.71	90.91
Dres^[23]	法国	21	12/9	12.0	0.76（0.60，0.93）	8	2	9	2	76.00	78.00
Cheng^[22]	中国	56	29/27	13.4	0.88（0.79，0.97）	37	2	10	7	84.80	82.60

第一作者	国家	例数	性别比（例，男/女）	阈值（%）	AUC（95%CI）	真阳性值	假阳性值	真阴性值	假阴性值	敏感度（%）	特异度（%）
Farghaly^[2]	埃及	30	13/17	14.9	0.80（0.66，0.92）	13	5	9	3	81.25	65.00
Chien^[12]	中国	52	37/15	20.0	0.93（0.85，1.00）	37	1	10	4	91.00	88.00
Maraghi^[24]	埃及	40	26/14	20.0	0.96（-）	27	1	7	5	85.71	90.91
Dres^[23]	法国	21	12/9	12.0	0.76（0.60，0.93）	8	2	9	2	76.00	78.00
Cheng^[22]	中国	56	29/27	13.4	0.88（0.79，0.97）	37	2	10	7	84.80	82.60

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