Ítem
Acceso Abierto
Predictive value of dynamic arterial elastance for vasopressor withdrawal: a systematic review and meta-analysis
Título de la revista
Autores
Salazar Ruíz, Sergio
Alvarado Sánchez, Jorge Iván
Caicedo Ruiz, Juan Daniel
Diaztagle Fernández, Juan José
Cárdenas Bolivar, Yenny Rocío
Carreño Hernandez, Fredy Leonardo
Mora Salamanca, Andrés Felipe
Montañez Nariño, Andrea Valentina
Stozitzky Ríos, María Valentina
Santacruz Herrera, Carlos
Archivos
Fecha
2024-10-31
Directores
Alvarado Sánchez, Jorge Iván
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Editor
Universidad del Rosario
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Resumen
La elastancia arterial dinámica (Eadyn) ha sido investigada por su capacidad para predecir la hipotensión durante la disminución de vasopresores. Nuestro estudio se centró en evaluar el rendimiento de Eadyn en el contexto de pacientes adultos críticamente enfermos ingresados en la unidad de cuidados intensivos, independientemente del diagnóstico.
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. Main body 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.
Palabras clave
Elastancia arterial dinámica , Retiro soporte vasopresor , Criticamente enfermo , EaDyn , Vasopresor , UCI , Cuidado crítico , Terapia de fluidos , Presion de pulso , Volumen sistólico , Revisión sistematica
Keywords
Critical care , Fluid therapy , Pulse pressure , Stroke volume , Blood flow velocity predictive value of tests , Systematic review
