Invasive-noninvasive Sequential Ventilation for the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Autor: | Jian-Da Huang, Dan-Fei Zhou, Tong-Jie Gu, Jun Ying, Zhi-Lin Hu |
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Rok vydání: | 2018 |
Předmět: |
Male
Acute exacerbation of chronic obstructive pulmonary disease Databases Factual medicine.medical_treatment Pulmonary infection law.invention Workflow 03 medical and health sciences Pulmonary Disease Chronic Obstructive 0302 clinical medicine Randomized controlled trial law Drug Discovery medicine Humans 030212 general & internal medicine Aged Mechanical ventilation business.industry Incidence (epidemiology) Organic Chemistry General Medicine Pneumonia Middle Aged medicine.disease Respiration Artificial Confidence interval Computer Science Applications Treatment Outcome 030228 respiratory system Anesthesia Relative risk Breathing Disease Progression Female business |
Zdroj: | Combinatorial chemistryhigh throughput screening. 22(3) |
ISSN: | 1875-5402 |
Popis: | Background: The study aimed to evaluate the efficacy and safety of invasivenoninvasive sequential ventilation versus invasive ventilation in the treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD). Method: PubMed, Cochrane, Embase, Wanfang, CNKI, VIP database were searched by the index words to identify the qualified RCTs, and relevant literature sources were also searched. The latest research was conducted in June 2017. Relative Risks (RR), and Mean Difference (MD) along with 95% confidence interval (95% CI) were used to analyze the main outcomes. Result: Twenty-nine RCTs were involved in this analysis of 1061 patients in the invasivenoninvasive sequential ventilation group (In-non group) and 1074 patients in the invasive ventilation group (In group). The results indicated that compared with the invasive ventilation, invasive-noninvasive sequential ventilation would significantly decrease the incidence of VAP (RR:0.20, 95%CI: 0.16-0.26), mortality (RR:0.38, 95%CI: 0.26-0.55), reintubation (RR:0.39, 95%CI: 0.27-0.55); and statistically reduced the duration of invasive ventilation (MD:-9.23, 95%CI: -10.65, -7.82), the total duration of mechanical ventilation (MD:-4.91, 95%CI: -5.99, -3.83), and the length of stay in the ICU (MD:-5.10, 95%CI: -5.43, -4.76). Conclusion: The results demonstrated that the application of noninvasive sequential ventilation after invasive ventilation at the pulmonary infection control window has a significant influence on VAP incidence, mortality, and the length of stay in the ICU, but further well-designed, adequately powered RCTs are required to validate the conclusion. |
Databáze: | OpenAIRE |
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