关键词: 重症监护病房；气管插管拔除；吞咽障碍；危险因素；Meta分析

Abstract: Objective: To systematically review the risk factors of Post-extubation Dysphagia (PED) among patients in intensive care units, so as to provide basis for timely identification of those with high risk of PED and take effective preventive measures. Methods: We searched PubMed, Web of Science, Cochrane Library, Embase, CNKI, Wanfang data, VIP, and CBM databases from inception to February 6,2020. Literatures on potential risk factors of PED among patients in intensive care units were reviewed. Cochrane handbook 5.1.0, Newcastle-Ottawa scale and AHRQ Quality Assessment Forms were used to perform quality appraisal. Review Manager 5.3 was used to perform Meta-analysis. Results: A total of 19 studies, including 5293 patients were analyzed. Significant risk factors for PED included age [MD=6.23, 95% CI (4.52-7.95)], gender [OR=0.75, 95% CI (0.60-0.94)], intubation duration [MD=66.46, 95%CI (58.12-74.79)], with heart failure [OR=2.65, 95%CI (1.84-3.82)], arrhythmia [OR=1.87, 95%CI (1.08-3.26)], atrial fibrillation or atrial flutter [OR=2.74, 95%CI (1.75-4.28)], chronic kidney disease [OR=3.66, 95%CI (2.38-5.63)], postoperative cerebrovascular accident [RR=4.37, 95%CI (1.68-11.35)], left ventricular ejection fraction [OR=0.57, 95%CI (0.38-0.85)], examination with esophageal ultrasound [RR=1.83, 95%CI (1.05-3.19)], APACHE II score [MD=3.68, 95% CI (1.00-6.35)] and the admission way to ICU [OR=2.84, 95% CI (1.05-7.71)]. Conclusion: Age>65y, female, with long tracheal intubation time, with heart, cerebrovascular and kidney diseases, low left ventricular ejection fraction, esophageal ultrasound usage, high APACHE II score and emergency admission to ICU are risk factors of PED.

Key words: Intensive Care Unit; airway extubation; dysphagia; risk factor; Meta-analysis