Influencing factors of aspiration in neurological critically ill patients: a Meta-analysis

ZHANG Yang; DIAO Haiqing; Li Mengyue; TIAN Ting; LIU Xiaoguang; MA Qiang; LU Guangyu; YU Hailong; LI Yuping

doi:10.7619/jcmp.20242193

Journal of Clinical Medicine in Practice > 2025 > 29(1): 118-124. > DOI: 10.7619/jcmp.20242193

ZHANG Yang, DIAO Haiqing, Li Mengyue, TIAN Ting, LIU Xiaoguang, MA Qiang, LU Guangyu, YU Hailong, LI Yuping. Influencing factors of aspiration in neurological critically ill patients: a Meta-analysis[J]. Journal of Clinical Medicine in Practice, 2025, 29(1): 118-124. DOI: 10.7619/jcmp.20242193

Citation:

PDF (4773 KB)

Influencing factors of aspiration in neurological critically ill patients: a Meta-analysis

ZHANG Yang¹,
DIAO Haiqing¹,
Li Mengyue¹,
TIAN Ting²,
LIU Xiaoguang^{3, 4},
MA Qiang^{3, 4},
LU Guangyu²,
YU Hailong^{4, 5},
LI Yuping^{3, 4,}

1.
School of Nursing, Yangzhou University, Yangzhou, Jiangsu, 225009
2.
School of Public Health, Yangzhou University, Yangzhou, Jiangsu, 225009
3.
Neurosurgery Department, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, 225001
4.
Neurocritical Care Unit, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, 225001
5.
Neurology Department, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, 225001

More Information

Received Date: May 23, 2024
Revised Date: June 25, 2024

Graphical Abstract

Abstract

Abstract

Objective
To evaluate the influencing factors of aspiration in neurological critically ill patients by Meta-analysis.
Methods
PubMed, Embase, Web of Science, CNKI, and Wanfang Data were searched from inception to 1 October, 2023, to obtain relevant studies on influencing factors of aspiration in neurological critically ill patients. The literature screening, data extraction and quality evaluation were completed by two researchers. RevMan 5.4 and Stata 13.0 software were applied for pooled Meta-analysisand assessed publication bias, respectively.
Results
A total of 8 articles, including 1, 315 neurocritical care patients, were included in this study. Nine influencing factors related to aspiration were extracted for Meta-analysis. The Meta-analysis results showed that the three influencing factors that caused aspiration in neurocritical care patients were stroke history (OR=5.03, 95%CI, 2.71 to 9.32, P < 0.000 01), National Institutes of Health Stroke Scale (NIHSS) score >10 (OR=3.35, 95%CI, 1.75 to 6.42, P=0.000 3), and gastric residual volume >150 mL (OR=7.13, 95%CI, 2.55 to 9.96, P=0.001).
Conclusion
This study provides a scientific basis for clinical healthcare professionals to early identify high-risk patients for aspiration, take targeted intervention measures, and prevent the occurrence of aspiration.
- neurocritical care patients,
- aspiration,
- influencing factors,
- Meta-analysis

FullText(HTML)

References (47)

References

[1]	陈雨晴, 王淑雅, 张琳琳, 等. 2022—2023年神经重症进展与展望[J]. 中国急救医学, 2024, 44(1): 30-37.
[2]	SUTTER R, MEYER-ZEHNDER B, BAUMANN S M, et al. Advance directives in the neurocritically ill: a systematic review[J]. Crit Care Med, 2020, 48(8): 1188-1195. doi: 10.1097/CCM.0000000000004388
[3]	QARYOUTI D, GREENE-CHANDOS D. Neurocritical care aspects of ischemic stroke management[J]. Crit Care Clin, 2023, 39(1): 55-70. doi: 10.1016/j.ccc.2022.07.005
[4]	TERAMOTO S. The current definition, epidemiology, animal models and a novel therapeutic strategy for aspiration pneumonia[J]. Respir Investig, 2022, 60(1): 45-55. doi: 10.1016/j.resinv.2021.09.012
[5]	PRINTZA A, KYRGIDIS A, PAVLIDOU E, et al. Reliability and validity of the eating assessment tool-10(greek adaptation) in neurogenic and head and neck cancer-related oropharyngeal dysphagia[J]. Eur Arch Otorhinolaryngol, 2018, 275: 1861-1868. doi: 10.1007/s00405-018-5001-9
[6]	GUPTE T, KNACK A, CRAMER J D. Mortality from aspiration pneumonia: Incidence, trends, and risk factors[J]. Dysphagia, 2022, 37(6): 1493-1500. doi: 10.1007/s00455-022-10412-w
[7]	WON J H, BYUN S J, OH B M, et al. Risk and mortality of aspiration pneumonia in Parkinson's disease: a nationwide database study[J]. Sci Rep, 2021, 11(1): 6597. doi: 10.1038/s41598-021-86011-w
[8]	詹昱新, 杨中善, 许妮娜, 等. 神经外科ICU患者肠内营养支持误吸预防的最佳证据总结[J]. 护理学杂志, 2018, 33(24): 82-86.
[9]	SHIRASU H, YOKOTA T, HAMAUCHI S, et al. Risk factors for aspiration pneumonia during concurrent chemoradiotherapy or bio-radiotherapy for head and neck cancer[J]. BMC cancer, 2020, 20(1): 1-10. doi: 10.1186/s12885-019-6169-0
[10]	王彩虹, 黄德斌, 刘霞琴. 重症监护病房成人患者显性误吸的危险因素分析及预防措施[J]. 中国当代医药, 2023, 30(11): 71-75.
[11]	俞玲英, 王晓磊, 沈晓芳, 等. 缺血性脑卒中患者住院期间误吸的危险因素及预测模型构建[J]. 实用临床医药杂志, 2024, 28(9): 103-108.
[12]	焦帅, 刘珊娜, 肖倩. 神经外科危重症患者误吸防治与管理循证护理实践[J]. 中国初级卫生保健, 2022, 36(5): 110-112.
[13]	中华医学会神经病学分会神经重症协作组. 神经重症监护病房建设中国专家共识[J]. 中华神经科杂志, 2014, 47(1): 269-273.
[14]	曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具[J]. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
[15]	CUELLO-GARCIA C A, SCHVNEMANN H J. Update of the agency for healthcare research and quality guidance on using nonrandomized studies in evidence syntheses[J]. J Clin Epidemiol, 2022, 152: 307-308. doi: 10.1016/j.jclinepi.2022.10.010
[16]	李佳, 牛蓓蓓, 肖倩, 等. 神经外科ICU机械通气患者胃内容物误吸的危险因素分析[J]. 中华现代护理杂志, 2017, 23(15): 2041-2045.
[17]	彭宇, 沙丽艳, 刘子龙, 等. 重症脑出血患者肠内营养支持发生误吸风险预测模型的构建及验证[J]. 中国护理管理, 2022, 22(9): 1391-1397.
[18]	余灵芝, 林兴, 朱秀梅, 等. 基于列线图构建重症颅脑损伤患者肠内营养误吸风险预测模型研究[J]. 创伤与急危重病医学, 2022, 10(6): 467-470.
[19]	肖倩, 王艳玲, 吴瑛, 等. 神经外科ICU患者胃内容物反流误吸的影响因素分析[J]. 护理学报, 2014, 21(7): 50-53.
[20]	牛蓓蓓, 李佳, 王军, 等. 神经外科监护室护士预防胃内容物误吸指南实施现状调查与分析[J]. 中华现代护理杂志, 2018, 24(13): 1517-1521.
[21]	王龙芳, 唐雪花, 张潇潇. 重症脑梗死患者肠内营养误吸的影响因素与护理对策[J]. 海南医学, 2019, 30(16): 2167-2169.
[22]	茅彦, 汪莉莉, 徐玲玲. 神经外科昏迷患者鼻饲中发生误吸的原因分析与护理对策[J]. 中国现代医生, 2021, 59(14): 178-181.
[23]	张丽, 叶健晓, 王燕飞. EICU重症脑卒中患者发生误吸的相关因素分析[J]. 中国现代医生, 2021, 59(12): 20-23.
[24]	MISTRY E A, YEATTS S D, KHATRI P, et al. National institutes of health stroke scale as an outcome in stroke research: value of ancova over analyzing change from baseline[J]. Stroke, 2022, 53(4): e150-e155.
[25]	陈耀龙, 李幼平, 杜亮等. 医学研究中证据分级和推荐强度的演进[J]. 中国循证医学杂志, 2008, 8(2): 127-133.
[26]	NIEDERMAN M S, CILLONIZ C. Aspiration pneumonia[J]. Rev Esp Quimioter, 2022, 35(Suppl 1): 73-77.
[27]	MCGINNISS J E, WHITESIDE S A, DEEK R A, et al. The lung allograft microbiome associates with pepsin, inflammation, and primary graft dysfunction[J]. Am J Respir Crit Care Med, 2022, 206(12): 1508-1521. doi: 10.1164/rccm.202112-2786OC
[28]	HALLAL C, CHAVES V S, BORGES G C, et al. Acid and weakly acidic gastroesophageal reflux and pepsin isoforms (A and C) in tracheal secretions of critically ill children[J]. Chest, 2015, 148(2): 333-339. doi: 10.1378/chest.14-1967
[29]	刘彦麟, 丁亚萍, 刘世晴, 等. 不同筛查工具对脑卒中后误吸筛查准确性的网状Meta分析[J]. 护理学杂志, 2021, 36(2): 93-97.
[30]	SABRY A, ABOU-ELSAAD T. Pharyngeal residue severity and aspiration risk in stroke patient using fiber-optic endoscopic evaluation of swallowing[J]. Folia Phoniatr Logop, 2023, 75(3): 158-163. doi: 10.1159/000528204
[31]	KEEFFE S T. Use of modified diets to prevent aspiration in oropharyngeal dysphagia: Is current practice justified[J]. BMC geriatrics, 2018, 18: 1-10. doi: 10.1186/s12877-017-0691-1
[32]	LABEIT B, MICHOU E, HAMDY S, et al. The assessment of dysphagia after stroke: state of the art and future directions[J]. Lancet Neurol, 2023, 22(9): 858-870. doi: 10.1016/S1474-4422(23)00153-9
[33]	LEONARD R, MILES A, ALLEN J. Bolus clearance ratio elevated in patients with neurogenic dysphagia compared with healthy adults: A measure of pharyngeal efficiency[J]. Am J Speech Lang Pathol, 2023, 32(1): 107-114. doi: 10.1044/2022_AJSLP-22-00199
[34]	PHAN T G, KOOBLAL T, MATLEY C, et al. Stroke severity versus dysphagia screen as driver for post-stroke pneumonia[J]. Front Neurol, 2019, 10: 16. doi: 10.3389/fneur.2019.00016
[35]	LIN W C, HUANG C Y, LEE L F, et al. lnitial national institute of health stroke scale to early predict the improvementof swallowing in patients with acute ischemic stroke[J]. J Stroke Cerebrovasc Dis, 2019, 28(10): 104297. doi: 10.1016/j.jstrokecerebrovasdis.2019.07.013
[36]	GOELEN N, JANSSEN P, TACK J, et al. Continuous assessment of gastric motility and its relation to gastric emptying in adult critically ill patients[J]. JPEN J Parenter Enteral Nutr, 2021, 45(8): 1779-1784. doi: 10.1002/jpen.2037
[37]	郑亚东, 肖虹, 高英. 鼻肠管肠内营养在神经外科昏迷患者营养支持中的应用[J]. 实用临床医药杂志, 2017, (3): 65-67.
[38]	ATASEVER A G, OZCAN P E, KASALI K, et al. The frequency, risk factors, and complications of gastrointestinal dysfunction during enteral nutrition in critically ill patients[J]. Ther Clin Risk Manag, 2018, 14: 385-391. doi: 10.2147/TCRM.S158492
[39]	CHAPMAN M J, BESANKO L K, BURGSTAD C M, et al. Gastric emptying of a liquid nutrient meal in the critically ill: relationship between scintigraphic and carbon breath test measurement[J]. Gut, 2011, 60(10): 1336-43. doi: 10.1136/gut.2010.227934
[40]	BOUVET L, ZIELESKIEWICZ L, LOUBRADOU E, et al. Reliability of gastric suctioning compared with ultrasound assessment of residual gastric volume: a prospective multicentre cohort study[J]. Anaesthesia, 2020, 75(3): 323-330. doi: 10.1111/anae.14915
[41]	田飞, 米元元, 刘静兰, 等. 超声监测胃残余量对重症患者肠内营养效果的Meta分析[J]. 解放军护理杂志, 2021, 38(10): 47-53, 72.
[42]	周文杰, 阳晓丽, 李斌, 等. 不同喂养方式对重型颅脑损伤患者肠内营养并发症影响的Meta分析[J]. 护理实践与研究, 2022, 19(1): 51-57.
[43]	王兰, 李清念, 黄素芳, 等. 重型颅脑损伤患者行鼻胃管与鼻肠管肠内营养所致并发症Meta分析[J]. 护理学杂志, 2020, 35(3): 80-83.
[44]	TAYLOR S J, SAYER K, WHITE P. Nasointestinal tube placement: Techniques that increase success[J]. J Intensive Care Soc, 2023, 24(1): 62-70. doi: 10.1177/17511437221095336
[45]	QIN Y, LIU M, GUO F, et al. The efficacy of parenteral nutrition and enteral nutrition supports in traumatic brain injury: A systemic review and network meta-analysis[J]. Emerg Med Int, 2023, 2023: 8867614.
[46]	LI Y, LIU C, LUO X, et al. Controlling nutritional status score and prognostic nutrition index predict the outcome after severe traumatic brain injury[J]. Nutr Neurosci, 2022, 25(4): 690-697. doi: 10.1080/1028415X.2020.1804097
[47]	HILL A, HEYLAND D K, ORTIZ REYES L A, et al. Combination of enteral and parenteral nutrition in the acute phase of critical illness: An updated systematic review and meta-analysis[J]. Parenter Enteral Nutr, 2022, 46(2): 395-410. doi: 10.1002/jpen.2125

[1]	XU Mingkui, CHEN Meixiong, XU Riming, LIN Yewu, LUO Yuantai, CHEN Yingwei, ZHOU Li. Clinical efficacy of minimally invasive transforaminal lumbar interbody fusion by lower Quadrant channel through the muscle gap approach in treatment of lumbar degenerative disease[J]. Journal of Clinical Medicine in Practice, 2022, 26(11): 94-99. DOI: 10.7619/jcmp.20214699
[2]	LI Ling, HUANG Rong, ZHOU Yumei. Value of enhanced recovery after surgery in patients undergoing minimally invasive transforaminal lumbar interbody fusion during perioperative period[J]. Journal of Clinical Medicine in Practice, 2022, 26(4): 42-45. DOI: 10.7619/jcmp.20212685
[3]	WANG Liqin, FANG Jing. Effect of percutaneous transforaminal endoscopic surgical system technique in the treatment of lumbar disc herniation combined with nerve root canal stenosis[J]. Journal of Clinical Medicine in Practice, 2020, 24(20): 22-25. DOI: 10.7619/jcmp.202020006
[4]	FEI Yanqiang, LI Xiaolong, JIANG Wenchao, GAO Xin. Middle and long-term clinical efficacy of modified transforaminal lumbar interbody fusion in the treatment of lumbar spondylolisthesis[J]. Journal of Clinical Medicine in Practice, 2020, 24(16): 74-76,81. DOI: 10.7619/jcmp.202016021
[5]	LI Ying, XIE Zhaolin, TAN Haitao, JIANG Jianzhong, HUANG Shengbin. Effect of extralateral approach interbody fusion in lumbar degenerative diseases[J]. Journal of Clinical Medicine in Practice, 2019, 23(7): 99-101, 105. DOI: 10.7619/jcmp.201907026
[6]	WANG Yuqiang, JIN Haichao, LI Zhonghai, LI He, SU Xuetao. Curative effect of MI-TLIF under expansion channel combined with pedicle screw fixation on treatment of patients with lumbar degenerative scoliosis complicated with spinal stenosis[J]. Journal of Clinical Medicine in Practice, 2017, (7): 67-70. DOI: 10.7619/jcmp.201707018
[7]	LI Yi, ZHAN Youda, LI Hongbing, XIE Yong. Effect comparison between minimally invasive surgery transforaminal lumbar interbody fusion and conventional open posterior surgery in treatment of lumbar degenerative disease[J]. Journal of Clinical Medicine in Practice, 2015, (5): 67-70. DOI: 10.7619/jcmp.201505021
[8]	ZHANG Qingjun, SHI Zheng. Effect of THESSYS percutaneous transformational endoscopic technique on treatment of lumbar disc herniation[J]. Journal of Clinical Medicine in Practice, 2014, (19): 56-58. DOI: 10.7619/jcmp.201419017
[9]	JU Baolan, YANG Yangping, TIAN Tian, LI Zhenzhou. Nursing experience of lumbar disc herniation treated with percutaneous posterolateral foraminoplasty[J]. Journal of Clinical Medicine in Practice, 2014, (18): 46-48. DOI: 10.7619/jcmp.201418015
[10]	GAO Xinxing, LIU Xongzhi, QI Jie, GAO Baoquan, LIU Haijun. Clinical observation on the effect posterior approach of internal fixation with pedicle screws combine with interbody fusion cage in the treatment of senile lumbar disc herniation and lumbar spinal stenosis[J]. Journal of Clinical Medicine in Practice, 2014, (9): 76-78. DOI: 10.7619/jcmp.201409021

Cited By

Cited by

Periodical cited type(4)

1.	胡菀，朱侥侥，毛菲，龚玲丽. 酒精联合凡士林纱布包敷用于全厚层自体皮肤移植修复四肢皮肤缺损的效果. 实用临床医学. 2024(03): 91-93 .
2.	喻萍萍，孙华中，杨萌，高群，赵金都. 儿童医疗辅导照护干预模式在植入式输液港首次穿刺中的作用. 中国医刊. 2024(09): 986-990 .
3.	段梦娣，王征，马亚男. PICC置管后局部皮肤过敏患者使用氯己定醇的疗效观察. 河北医药. 2023(09): 1370-1372+1376 .
4.	赵静，石庆，张丽. 酒精湿敷治疗老年PICC置管固定敷贴致皮肤过敏的疗效分析. 皮肤病与性病. 2021(04): 482+485 .

Other cited types(0)

Get Citation

PDF

XML

Article views (67) PDF downloads (18) Cited by(4)

Turn off MathJax

Article Contents

Abstract

References

Influencing factors of aspiration in neurological critically ill patients: a Meta-analysis