Evidence map›Paper›PMID 32393393›Full record

SynthesisCritical care (London, England)2020

Brain natriuretic peptide to predict successful liberation from mechanical ventilation in critically ill patients: a systematic review and meta-analysis.

Jean Deschamps, Sarah K Andersen, Jordan Webber, Robin Featherstone, Meghan Sebastianski, Ben Vandermeer, Janek Senaratne, Sean M Bagshaw

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.1field-weighted citation impact, top 19% 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

7 citing papers in PubMed, 15 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Review
  5. [Natriuretic peptides in intensive care medicine].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2023
    Review
  6. Article
  7. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Jean DeschampsDepartment of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 8440 112 St. NW, Critical Care Medicine 2-124E Clinical Sciences Building, Edmonton, Alberta, T6G 2B7, Canada. jean3@ualberta.ca.ORCID http://orcid.org/0000-0002-4872-3334
Sarah K AndersenDepartment of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 8440 112 St. NW, Critical Care Medicine 2-124E Clinical Sciences Building, Edmonton, Alberta, T6G 2B7, Canada.
Jordan WebberDepartment of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 8440 112 St. NW, Critical Care Medicine 2-124E Clinical Sciences Building, Edmonton, Alberta, T6G 2B7, Canada.
Robin FeatherstoneAlberta Strategy for Patient Oriented Research (SPOR) SUPPORT Unit-Knowledge Translation Platform, University of Alberta, 4-472 Edmonton Clinical Health Academy, 11405-87 Avenue, Edmonton, Alberta, T6G 1C9, Canada.
Meghan SebastianskiKnowledge Translation Platform, Alberta SPOR SUPPORT Unit Department of Pediatrics, University of Alberta, 362-B Heritage Medical Research Centre (HMRC), Edmonton, Alberta, Canada.
Ben VandermeerAlberta Strategy for Patient Oriented Research (SPOR) SUPPORT Unit-Knowledge Translation Platform, University of Alberta, 4-472 Edmonton Clinical Health Academy, 11405-87 Avenue, Edmonton, Alberta, T6G 1C9, Canada.
Janek SenaratneDivision of Cardiology, Faculty of Medicine and Dentistry, University of Alberta, 8440 112 St. NW, Edmonton, Alberta, Canada.
Sean M BagshawDepartment of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 8440 112 St. NW, Critical Care Medicine 2-124E Clinical Sciences Building, Edmonton, Alberta, T6G 2B7, Canada.
University of Alberta · CA

Funding

Strategy for Patient Oriented Research (SP OR) SUPPORT Unit - Knowledge Translation Platform. Not applicable
6 · The paper itself

Abstract

backgroundPredicting successful liberation from mechanical ventilation (MV) in critically ill patients is challenging. Brain natriuretic peptide (BNP) has been proposed to help guide decision-making for readiness to liberate from MV following a spontaneous breathing trial (SBT).

methodsWe performed a systematic review and meta-analysis of randomized and prospective observational studies that measured BNP levels at the time of SBT in patients receiving MV. The primary endpoint was successful liberation from MV (absence of reintubation or non-invasive ventilation at 48 h). Statistical analyses included bi-variate and Moses-Littenberg models and DerSimonian-Laird pooling of areas under ROC curve (AUROC).

resultsA total of 731 articles were screened. Eighteen adult and 2 pediatric studies were fulfilled pre-specified eligibility. The measure of the relative variation of BNP during SBT (ΔBNP%) after exclusion of SBT failure by clinical criteria in adults yielded a sensitivity and specificity of 0.889 [0.831-0.929] and 0.828 [0.730-0.896] for successful liberation from MV, respectively, with a pooled AUROC of 0.92 [0.88-0.97]. The pooled AUROC for any method of analysis for absolute variation of BNP (ΔBNP), pre-SBT BNP, and post-SBT BNP were 0.89 [0.83-0.95], 0.77 [0.63-0.91], and 0.85 [0.80-0.90], respectively.

conclusionThe relative change in BNP during a SBT has potential value as an incremental tool after successful SBT to predict successful liberation from MV in adults. There is insufficient data to support the use of BNP in children or as an alternate test to clinical indices of SBT, or the use of ΔBNP, BNP-pre, and BNP-post as an alternate or incremental test.

trial registrationPROSPERO CRD42018087474 (6 February 2018).

Indexed as

Natriuretic Peptide, BrainRespiration, ArtificialAdultChildCritical IllnessHumansProspective StudiesVentilator WeaningNatriuretic Peptide, BrainCritical careIntensive careNatriuretic peptide (brain)Respiration (artificial)Ventilator weaning

Identifiers

PMID32393393
PMCPMC7216735
OpenAlexW3025661887

What OpenQuestion 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 OpenQuestion graph.