Effects of early extubation followed by noninvasive ventilation versus standard extubation on the duration of invasive mechanical ventilation in hypoxemic non-hypercapnic patients: a systematic review and individual patient data meta-analysis of randomized controlled trials

Autor: Rosanna Vaschetto, Alessandro Pecere, Gavin D. Perkins, Dipesh Mistry, Gianmaria Cammarota, Federico Longhini, Miguel Ferrer, Renata Pletsch-Assunção, Michele Carron, Francesca Moretto, Haibo Qiu, Francesco Della Corte, Francesco Barone-Adesi, Paolo Navalesi
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Critical Care, Vol 25, Iss 1, Pp 1-11 (2021)
Druh dokumentu: article
ISSN: 1364-8535
25680692
DOI: 10.1186/s13054-021-03595-5
Popis: Abstract Background Usefulness of noninvasive ventilation (NIV) in weaning patients with non-hypercapnic hypoxemic acute respiratory failure (hARF) is unclear. The study aims to assess in patients with non-hypercapnic hARF, the efficacy of NIV after early extubation, compared to standard weaning. Methods In this individual patient data meta-analysis, we searched EMBASE, Medline and Cochrane Central Register of Controlled Trials to identify potentially eligible randomized controlled trials published from database inception to October 2020. To be eligible, studies had to include patients treated with NIV after early extubation and compared to conventional weaning in adult non-hypercapnic hARF patients. Anonymized individual patient data from eligible studies were provided by study investigators. Using one-step and two-step meta-analysis models we tested the difference in total days spent on invasive ventilation. Results We screened 1605 records. Six studies were included in quantitative synthesis. Overall, 459 participants (mean [SD] age, 62 [15] years; 269 [59%] males) recovering from hARF were included in the analysis (233 in the intervention group and 226 controls). Participants receiving NIV had a shorter duration of invasive mechanical ventilation compared to control group (mean difference, − 3.43; 95% CI − 5.17 to − 1.69 days, p
Databáze: Directory of Open Access Journals
Externí odkaz: