Noninvasive vs invasive mechanical ventilation in intensive care patients

Matić, Ivo; Jurjević, Matija; Majerić-Kogler, Višnja; Šakić-Zdravčević, Katarina; Lučić, Ivo

doi:10.1097/00003643-200805001-00534

Cited by 1 publication

(5 citation statements)

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“…Third, it is impossible to disregard publication bias. The two included studies [20,21] were published by the same author, which may have diminished the validity of our result that PSV can lessen the length of mechanical breathing during weaning. Further research is needed on the subgroup of individuals with underlying cardiovascular problems and those who nd it di cult to wean.…”

Section: Discussionmentioning

confidence: 99%

“…The interventions of PS and T-Piece or CPAP included in the meta-analysis are outlined in Table 1. Eighteen of these studies [10,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]33] reported the primary outcome.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Nineteen studies [10, 14-18, 20-23, 25-33] compared T-piece and PSV, another two studies [19,24] compared T-piece, CPAP and PSV. As to modes of weaning, three studies [14,[20][21] focused on the di cult weaning. Esteban 1994 [15] NR [20] PS 8cm…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The search strategy identi ed 16517 studies, and the data were from 21 RCTs comprising 4636 patients [10,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] . Study sites included Spain, Switzerland, Croatia, China, Thailand, Turkey, Brazil, Africa, Pakistan and France.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Matic 2007 [21] PS Zhang 2014 [25] PS Faleh 2020 [31] PS 8 cm H2O, PEEP 0 cm H O, 30-120 min T-piece, 30-120 min Simple NR 30 15 Jamoussi 2020 [32] NR NR Simple T-piece: 6.87 ± 4.3 PSV: 6.06 ± 4.8 32 15…”

Section: T-piece 2hmentioning

confidence: 99%

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Comparison between T-piece or CPAP and pressure support ventilation in spontaneous breathing trials: a systematic review and meta-analysis

Wang

et al. 2023

Preprint

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Background The ideal time to wean off of a ventilator has been predicted using the spontaneous breathing trial (SBT). Which trial ought to be chosen with preference is still debatable. Among critically sick patients receiving mechanical ventilation (MV) our goal was to evaluate typical SBT modalities such as pressure support ventilation (PSV), continuous positive airway pressure (CPAP), and T-piece. Methods We searched the PubMed, Cochrane, Embase, Web of Science database for RCTs from inception to the 30th of Nov. 2022. We included RCTs involving adult patients (> 18 years) who underwent at least two different SBT methods. Primary outcome was extubation. Secondary outcomes were reintubation, mechanical ventilation duration, intensive care unit (ICU) mortality, and hospital mortality, intensive care unit (ICU) length of stay and hospital length of stay. Statistical analysis was conducted by using RevMan 5.4 and trial sequence analysis (TSA). Results were expressed as risk ratio (RR) or mean difference (MD) with accompanying 95% confidence interval (CI). Results Twenty-one RCTs comprising 4636 patients are included. The results of this meta-analysis showed that there was a significant difference in the successful extubation rate between the T-piece or CPAP group and PSV group (risk ratio [RR] = 0.93; 95% CI, 0.90–0.96; P < 0.00001; Chi2 = 7.86; I2 = 0%). In addition, there was statistically difference in the hospital mortality between 2 groups (risk ratio [RR] = 1.23; 95% CI, 1.01–1.49; P = 0.04; ChI2 = 3.07; I2 = 0%). Compared with the PS group, the T-piece or CPAP group showed no significant difference in other secondary outcomes. Further subgroup analysis found that the duration of mechanical ventilation appeared to be shorter in the PSV group than in the T-piece group in patients with difficult weaning. Conclusions The prognostic power of T-piece, CPAP, and PSV as SBTs for effective extubation in critically ill patients is seen as being equivalent. PSV has the potential to increase the success rate of patient extubation when compared to T-piece or CPAP. In addition, the PSV group appeared to have an advantage over the other group in lowering hospital mortality and cutting the time those patients with difficult weaning.

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Section: Discussionmentioning

confidence: 99%