{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T14:24:05Z","timestamp":1762957445257,"version":"build-2065373602"},"reference-count":49,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T00:00:00Z","timestamp":1717027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Roche Diagnostics Ltd. (Bazel, Switzerland)","award":["9110193179"],"award-info":[{"award-number":["9110193179"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: It is unclear whether other cardiac biomarkers than NT-proBNP can be useful in the risk stratification of patients weaning from mechanical ventilation. The aim of this study is to summarize the role of ischemic cardiac biomarkers in predicting spontaneous breathing trial (SBT) or extubation failure. Methods: We systematically searched Embase, MEDLINE, Web of Science, and Cochrane Central for studies published before January 2024 that reported the association between ischemic cardiac biomarkers and SBT or extubation failure. Data were extracted using a standardized form and methodological assessment was performed using the QUIPS tool. Results: Seven observational studies investigating four ischemic cardiac biomarkers (Troponin-T, Troponin-I, CK-MB, Myoglobin) were included. One study reported a higher peak Troponin-I in patients with extubation failure compared to extubation success (50 ng\/L [IQR, 20\u2013215] versus 30 ng\/L [IQR, 10\u201386], p = 0.01). A second study found that Troponin-I measured before the SBT was higher in patients with SBT failure in comparison to patients with SBT success (100 \u00b1 80 ng\/L versus 70 \u00b1 130 ng\/L, p = 0.03). A third study reported a higher CK-MB measured at the end of the SBT in patients with weaning failure (SBT or extubation failure) in comparison to weaning success (8.77 \u00b1 20.5 ng\/mL versus 1.52 \u00b1 1.42 ng\/mL, p = 0.047). Troponin-T and Myoglobin as well as Troponin-I and CK-MB measured at other time points were not found to be related to SBT or extubation failure. However, most studies were underpowered and with high risk of bias. Conclusions: The association with SBT or extubation failure is limited for Troponin-I and CK-MB and appears absent for Troponin-T and Myoglobin, but available studies are hampered by significant methodological drawbacks. To more definitively determine the role of ischemic cardiac biomarkers, future studies should prioritize larger sample sizes, including patients at risk of cardiac disease, using stringent SBTs and structured timing of laboratory measurements before and after SBT.<\/jats:p>","DOI":"10.3390\/jcm13113242","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T10:42:34Z","timestamp":1717065754000},"page":"3242","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Value of Ischemic Cardiac Biomarkers to Predict Spontaneous Breathing Trial or Extubation Failure: A Systematic Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5759-2217","authenticated-orcid":false,"given":"Carline N. L.","family":"Groenland","sequence":"first","affiliation":[{"name":"Department of Intensive Care, Erasmus MC, 3015 GD Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maud A.","family":"Blijleven","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Erasmus MC, 3015 GD Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Imane","family":"Ramzi","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Erasmus MC, 3015 GD Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6727-8635","authenticated-orcid":false,"given":"Eric A.","family":"Dubois","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Erasmus MC, 3015 GD Rotterdam, The Netherlands"},{"name":"Department of Cardiology, Thorax Center, Cardiovascular Institute, Erasmus MC, 3015 GD Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leo","family":"Heunks","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Erasmus MC, 3015 GD Rotterdam, The Netherlands"},{"name":"Department of Intensive Care, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik","family":"Endeman","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Erasmus MC, 3015 GD Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2868-0920","authenticated-orcid":false,"given":"Evert-Jan","family":"Wils","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Franciscus Gasthuis & Vlietland Ziekenhuis, 3045 PM Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0692-9147","authenticated-orcid":false,"given":"Vivan J. M.","family":"Baggen","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Erasmus MC, 3015 GD Rotterdam, The Netherlands"},{"name":"Department of Cardiology, Thorax Center, Cardiovascular Institute, Erasmus MC, 3015 GD Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/S2213-2600(22)00449-0","article-title":"Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): A multicentre, prospective, observational cohort study","volume":"11","author":"Pham","year":"2023","journal-title":"Lancet Respir. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1164\/rccm.201208-1523CI","article-title":"The decision to extubate in the intensive care unit","volume":"187","author":"Thille","year":"2013","journal-title":"Am. J. 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