Monitorización de la presión esofágica durante la ventilación mecánica en pacientes críticos adultos: revisión sistemática y metaanálisis / Esophageal pressure monitoring during mechanical ventilation in critically ill adult patients: A systematic review and meta-analysis

Objetivo: Evaluar los efectos de la monitorización de la presión esofágica en pacientes adultos con requerimiento de ventilación mecánica en la Unidad de Terapia Intensiva. Diseño: Revisión sistemática (Registro PROSPERO CRD42018118583). Ámbito: Terapia intensiva. Cuidados críticos. Pacientes o participantes Adultos con requerimiento de ventilación mecánica en la Unidad de Terapia Intensiva. Intervenciones Monitorización de la presión esofágica. Variables de interés principales Mortalidad en terapia intensiva, días de hospitalización en terapia intensiva, días de ventilación mecánica, eventos adversos. Resultados Se incluyeron 4 estudios con 301 participantes. La monitorización de la presión esofágica durante la ventilación mecánica produciría poco o ningún efecto sobre la mortalidad en terapia intensiva a los 28 días (RR 0,74; IC 95% 0,31 a 1,76; participantes 261; estudios 2; I2: 68%), poca o ninguna diferencia en los días de hospitalización en terapia intensiva (DM 0,48; IC 95% −1,90 a 2,85; participantes 284; estudios 3; I2: 7%) o los eventos adversos (RR 0,74; IC 95% 0,50 a 1,09; participantes 261; estudios 2; I2: 0%). Existe incertidumbre sobre si la monitorización de la presión esofágica reduce los días de ventilación mecánica. Conclusiones La evidencia de certeza baja o muy baja indica que la monitorización de la presión esofágica durante la ventilación mecánica produciría poco o ningún efecto sobre la mortalidad en terapia intensiva, los días de hospitalización en terapia intensiva o ventilación mecánica y los eventos adversos. (AU)

Objective: To evaluate the effects of esophageal pressure monitoring in adult patients with mechanical ventilation requirements in the Intensive Care Unit. Design A systematic review (PROSPERO Register CRD42018118583) was carried out. Setting Intensive therapy. Critical care. Patients or participants Adults with mechanical ventilation requirement in the Intensive Care Unit. Interventions Esophageal pressure monitoring. Outcomes of interest Intensive Care Unit mortality and length of stay, mechanical ventilation days, adverse events. Results Four studies with 301 participants were included. Esophageal pressure monitoring during mechanical ventilation had little or no effect on mortality in intensive care at 28 days (RR 0.74; 95% CI 0.31 to 1.76; participants 261; studies 2; I2: 68%), with little or no differences in ICU length of stay (MD 0.48; 95% CI −1.90 to 2.85; participants 284; studies 3; I2: 7%) or impact upon adverse events (RR 0.74; 95% CI 0.50 to 1.09; participants 261; studies 2; I2: 0%). There is uncertainty about whether esophageal pressure monitoring reduces the duration of mechanical ventilation. Conclusions Evidence of low or very low certainty indicates that esophageal pressure monitoring during mechanical ventilation would produce little or no effect on Intensive Care Unit mortality, Intensive Care Unit length of stay, days on mechanical ventilation or adverse events. (AU)

Esophageal pressure monitoring during mechanical ventilation in critically ill adult patients: A systematic review and meta-analysis.

OBJECTIVE: To evaluate the effects of esophageal pressure monitoring in adult patients with mechanical ventilation requirements in the Intensive Care Unit. DESIGN: A systematic review (PROSPERO Register CRD42018118583) was carried out. SETTING: Intensive therapy. Critical care. PATIENTS OR PARTICIPANTS: Adults with mechanical ventilation requirement in the Intensive Care Unit. INTERVENTIONS: Esophageal pressure monitoring. OUTCOMES OF INTEREST: Intensive Care Unit mortality and length of stay, mechanical ventilation days, adverse events. RESULTS: Four studies with 301 participants were included. Esophageal pressure monitoring during mechanical ventilation had little or no effect on mortality in intensive care at 28 days (RR 0.74; 95% CI 0.31-1.76; participants 261; studies 2; I2: 68%), with little or no differences in ICU length of stay (MD 0.48; 95% CI -1.90 to 2.85; participants 284; studies 3; I2: 7%) or impact upon adverse events (RR 0.74; 95% CI 0.50-1.09; participants 261; studies 2; I2: 0%). There is uncertainty about whether esophageal pressure monitoring reduces the duration of mechanical ventilation. CONCLUSIONS: Evidence of low or very low certainty indicates that esophageal pressure monitoring during mechanical ventilation would produce little or no effect on Intensive Care Unit mortality, Intensive Care Unit length of stay, days on mechanical ventilation or adverse events.