Non invasive ventilation versus synchronized intermittent mandatory ventilation with pressure support in weaning of COPD patients: Comparative study

El-Shimy, Wafaa S.; Barima, Mohammad A.; El-Magd, Gehan H. Abo; Mansour, Samar A.

doi:10.1016/j.ejcdt.2013.03.006

Cited by 7 publications

(3 citation statements)

References 24 publications

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“…Other mortality outcomes were infrequently reported, such that meta-analyses included only three 30-day studies [13, 36, 37], three 60-day studies [34, 35, 39] and three 90-day studies [13, 19, 38]. In the meta-analyses, the pooled OR for 30-day, 60-day and 90-day mortality was lower in NIV group, but the 95% HDI crossed one for each of these analyses (Supplementary Fig.…”

Section: Resultsmentioning

confidence: 99%

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Non-invasive ventilation as a strategy for weaning from invasive mechanical ventilation: a systematic review and Bayesian meta-analysis

et al. 2018

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PurposeA systematic review and meta-analysis was conducted to answer the question ‘In adults with respiratory failure requiring invasive ventilation for more than 24 h, does a weaning strategy with early extubation to non-invasive ventilation (NIV) compared to invasive ventilation weaning reduce all-cause hospital mortality?’MethodsWe included randomised and quasi-randomised controlled trials that evaluated the use of non-invasive ventilation, compared to invasive ventilation, as a weaning strategy in adults mechanically ventilated for at least 24 h. The EMBASE, MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL) bibliographic databases were searched from inception to February 2018. Bayesian hierarchical models were used to perform the meta-analysis. The primary outcome was mortality at hospital discharge. Secondary outcomes included mortality (30, 60, 90 and 180 days), quality of life, duration of invasive ventilation, weaning failure, length of stay [intensive care unit (ICU) and hospital] and adverse events. ResultsTwenty-five relevant studies involving 1609 patients were included in the quantitative analysis. Studies had moderate to high risk of bias due to risk of performance and detection bias. Mortality at hospital discharge was lower in the NIV weaning group compared to the invasive weaning group [pooled odds ratio (OR) 0.58, 95% highest density interval (HDI) 0.29–0.89]. Subgroup analyses showed lower pooled mortality at hospital discharge rates in NIV weaning than those in the control group in chronic obstructive pulmonary disease (COPD) patients (pooled OR 0.43, 95% HDI 0.13–0.81) and the effect is less certain in the mixed ICU population (pooled OR 0.88, 95% HDI 0.25–1.48). NIV weaning reduced the duration of invasive ventilation in patients [standardised mean difference (SMD) − 1.34, 95% HDI − 1.92 to − 0.77] and ICU length of stay (SMD − 0.70, 95% HDI − 0.94 to − 0.46). Reported rates of ventilator associated pneumonia (VAP) were lower in the NIV group. NIV weaning did not reduce overall hospital length of stay or long-term mortality. There were insufficient data to compare other adverse events and health-related quality of life.ConclusionsThe use of NIV in weaning from mechanical ventilation decreases hospital mortality, the incidence of VAP and ICU length of stay. NIV as a weaning strategy appears to be most beneficial in patients with COPD.Electronic supplementary materialThe online version of this article (10.1007/s00134-018-5434-z) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

“…Weaning failure was reported in 13 studies [13, 19, 24, 27–29, 31, 33, 34, 37, 38, 41, 43]. Marked heterogeneity across studies in the way that weaning failure was defined precluded meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

Non-invasive ventilation as a strategy for weaning from invasive mechanical ventilation: a systematic review and Bayesian meta-analysis

et al. 2018

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“…These conditions lead to chronic hypoxemia and hypercapnia that in turn cause acid–base shift in the blood and the cerebrospinal fluid (CSF) [ 2 , 4 ], alter the response of the respiratory control system to various stimuli, and affect the functions of all the body organs. Among different treatment options, long‐term use of non‐invasive ventilation (NIV), which can provide continuous positive airway pressure (CPAP) and supplemental oxygen treatment, has been proposed in various studies to mitigate the negative impacts of the disease and improve survival among COPD patients [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Non‐invasive ventilation treatment for patients with chronic obstructive pulmonary disease

Tehrani

Roum

2023

Healthcare Tech Letters

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Chronic obstructive pulmonary disease (COPD) affects the lives of millions of patients worldwide. Patients with advanced COPD may require non-invasive ventilation (NIV) to support the resultant deficiencies of the respiratory system. The purpose of this study was to evaluate the effects of varying the continuous positive airway pressure (CPAP) and oxygen supplementation components of NIV on simulated COPD patients by using an established and detailed model of the human respiratory system. The model used in the study simulates features of advanced COPD including the effects on the changes in ventilation control, increases in respiratory dead space and airway resistance, and the acid-base shifts in the blood seen in these patients over time. The results of the study have been compared with and found to be in general agreement with available clinical data. Our results demonstrate that under non-emergency conditions, low levels of oxygen supplementation combined with low levels of CPAP therapy seem to improve hypoxemia and hypercapnia in the model, whereas prolonged high-level CPAP and moderate-to-high levels of oxygen supplementation do not. The authors conclude that such modelling may be useful to help guide beneficial interventions for COPD patients using NIV.

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Role of Noninvasive Mechanical Ventilation in Difficult Weaning

Sehgal

Dhooria

Aggarwal

et al. 2016

Noninvasive Mechanical Ventilation

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Non invasive ventilation versus synchronized intermittent mandatory ventilation with pressure support in weaning of COPD patients: Comparative study

Cited by 7 publications

References 24 publications

Non-invasive ventilation as a strategy for weaning from invasive mechanical ventilation: a systematic review and Bayesian meta-analysis

Non-invasive ventilation as a strategy for weaning from invasive mechanical ventilation: a systematic review and Bayesian meta-analysis

Non‐invasive ventilation treatment for patients with chronic obstructive pulmonary disease

Role of Noninvasive Mechanical Ventilation in Difficult Weaning

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