Noninvasive versus invasive mechanical ventilation for immunocompromised patients with acute respiratory failure: a systematic review and meta-analysis

BMC Pulmonary Medicine

Research Article

Na Zhao¹  Lixi Zhang²  Kai Luo³  Qun Xu³  Zongru Li⁴  Jianqiang He⁵  Yong Ma⁵  Yi Li⁵  Xuezhong Yu⁵  Tao Wang⁵ 

[1] Department of Anesthesiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 100026, Beijing, China;Department of Cardiology, Peking Union Medical College Hospital, 100730, Beijing, China;Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, 100005, Beijing, China;Department of Pneumology, Peking Union Medical College Hospital, 100730, Beijing, China;Emergency Department, Peking Union Medical College Hospital, 100730, Beijing, China;

关键词: Noninvasive mechanical ventilation;    Invasive mechanical ventilation;    Acute respiratory failure;    Immunocompromised patients;    Systematic review;    Meta-analysis;   

DOI  :  10.1186/s12890-016-0289-y

 received in 2016-05-17, accepted in 2016-08-19,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundTo determine the effects of noninvasive mechanical ventilation (NIV) compared with invasive mechanical ventilation (IMV) as the initial mechanical ventilation on clinical outcomes when used for treatment of acute respiratory failure (ARF) in immunocompromised patients.MethodsWe searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the Chinese Biomedical Literature Database (CBM) and other databases. Subgroup analyses by disease severity and causes of immunodeficiency were also conducted.ResultsThirteen observational studies with a total of 2552 patients were included. Compared to IMV, NIV was shown to significantly reduce in-hospital mortality (OR 0.43, 95 % CI 0.23 to 0.80, P value = 0.007) and 30-day mortality (OR 0.34, 95 % CI 0.20 to 0.61, P value < 0.0001) in overall analysis. Subgroup analysis showed NIV had great advantage over IMV for less severe, AIDS, BMT and hematological malignancies patients in reducing mortality and duration of ICU stay.ConclusionsThe overall evidence we obtained shows NIV does more benefits or at least no harm to ARF patients with certain causes of immunodeficiency or who are less severe.

【 授权许可】

CC BY   
© The Author(s). 2016