Efficacy of long-term noninvasive positive pressure ventilation in stable hypercapnic COPD patients with respiratory failure: a meta-analysis of randomized controlled trials

Autor: Yu-wen Luo, Xin Chen, Rui Li, Wendi Pei, Kai Wang, Limei Xu, Hongfu Li, Hao Liao
Rok vydání: 2017
Předmět:
Time Factors
Exacerbation
medicine.medical_treatment
Vital Capacity
Subgroup analysis
International Journal of Chronic Obstructive Pulmonary Disease
030204 cardiovascular system & hematology
law.invention
Hypercapnia
Positive-Pressure Respiration
Pulmonary Disease
Chronic Obstructive
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
Risk Factors
law
Forced Expiratory Volume
Oxygen therapy
Odds Ratio
medicine
Respiratory muscle
Humans
COPD
gas change
Lung
Randomized Controlled Trials as Topic
Original Research
Chi-Square Distribution
Exercise Tolerance
Noninvasive Ventilation
Pulmonary Gas Exchange
business.industry
General Medicine
medicine.disease
mortality
Respiratory Muscles
respiratory tract diseases
meta-analysis
Treatment Outcome
030228 respiratory system
Respiratory failure
Anesthesia
noninvasive positive pressure ventilation
medicine.symptom
Respiratory Insufficiency
business
Zdroj: International Journal of Chronic Obstructive Pulmonary Disease
ISSN: 1178-2005
DOI: 10.2147/copd.s148422
Popis: Introduction The efficacy of long-term noninvasive positive pressure ventilation (NPPV) in stable hypercapnic COPD patients with respiratory failure remains unclear. The aim of this meta-analysis was to critically assess the efficacy of long-term NPPV on mortality, acute exacerbation, exercise capacity, symptoms and significant physiological parameters (lung function, respiratory muscle function and gas exchange). Patients and methods We performed an electronic literature search using the PubMed, Cochrane Library, Embase, OVID and Chinese Biomedical Literature Database in May 2017. Studies comparing treatment effects of NPPV with oxygen therapy in stable hypercapnic COPD patients with respiratory failure were conducted, and at least one of the following parameters were reviewed: frequency of acute exacerbation, mortality, lung function, respiratory muscle function, gas exchange, exercise capacity. Results Seven studies with 810 subjects were identified. The partial pressure of arterial carbon dioxide (PaCO2) significantly decreased in patients who received long-term NPPV (weighted mean difference [WMD] −3.73, 95% CI: −5.83 to −1.64, P=0.0005). No significant difference was found in mortality, partial pressure of arterial oxygen (PaO2), frequency of acute exacerbation, lung function, respiratory muscle function and exercise capacity. The subgroup analysis showed that NPPV significantly improved the survival of patients when it was targeted at greatly reducing hypercapnia (WMD 0.35, 95% CI: 0.19 to 0.64, P=0.0006). Conclusion The results indicate that long-term NPPV decreases the PaCO2 of stable hypercapnic COPD patients with respiratory failure and improves mortality with the aim of reducing PaCO2.
Video abstract
Databáze: OpenAIRE
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