Noninvasive Ventilation for Acute Respiratory Failure in Pediatric Patients: A Systematic Review and Meta-Analysis.

Autor:	Boghi D; Anesthesia and Intensive Care, Ospedale Filippo Del Ponte, Varese, Italy., Kim KW; Department of Anesthesiology and Pain Medicine, Inje UniversityIlsan Paik Hospital, Goyang, South Korea., Kim JH; Department of Anesthesiology and Pain Medicine, Inje UniversityIlsan Paik Hospital, Goyang, South Korea., Lee SI; Department of Anesthesiology and Pain Medicine, Inje UniversityIlsan Paik Hospital, Goyang, South Korea., Kim JY; Department of Anesthesiology and Pain Medicine, Inje UniversityIlsan Paik Hospital, Goyang, South Korea., Kim KT; Department of Anesthesiology and Pain Medicine, Inje UniversityIlsan Paik Hospital, Goyang, South Korea., Ambrosoli A; Anesthesia and Intensive Care, Ospedale Filippo Del Ponte, Varese, Italy., Guarneri G; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy., Landoni G; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.; Vita-Salute San Raffaele University, Milan, Italy., Cabrini L; Department of Biotechnology and Life Sciences, Università degli Studi dell'Insubria, Varese, Italy.; Intensive Care Units, Ospedale di Circolo, Varese, Italy.
Jazyk:	angličtina
Zdroj:	Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies [Pediatr Crit Care Med] 2023 Feb 01; Vol. 24 (2), pp. 123-132. Date of Electronic Publication: 2022 Dec 13.
DOI:	10.1097/PCC.0000000000003109
Abstrakt:	Objective: To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) on the use of noninvasive ventilation (NIV) for acute respiratory failure (ARF) in pediatric patients. Data Sources: We searched PubMed, EMBASE, the Cochrane Central Register of Clinical Trials, and Clinicaltrials.gov with a last update on July 31, 2022. Study Selection: We included RCTs comparing NIV with any comparator (standard oxygen therapy and high-flow nasal cannula [HFNC]) in pediatric patients with ARF. We excluded studies performed on neonates and on chronic respiratory failure patients. Data Extraction: Baseline characteristics, intubation rate, mortality, and hospital and ICU length of stays were extracted by trained investigators. Data Synthesis: We identified 15 RCTs (2,679 patients) for the final analyses. The intubation rate was 109 of 945 (11.5%) in the NIV group, and 158 of 1,086 (14.5%) in the control group (risk ratio, 0.791; 95% CI, 0.629-0.996; p = 0.046; I2 = 0%; number needed to treat = 31). Findings were strengthened after removing studies with intervention duration shorter than an hour and after excluding studies with cross-over as rescue treatment. There was no difference in mortality, and ICU and hospital length of stays. Conclusions: In pediatric patients, NIV applied for ARF might reduce the intubation rate compared with standard oxygen therapy or HFNC. No difference in mortality was observed. Competing Interests: The authors have disclosed that they do not have any potential conflicts of interest. (Copyright © 2022 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.)
Databáze:	MEDLINE
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