Noninvasive positive pressure ventilation as a weaning strategy for intubated adults with respiratory failure

Karen E. A. Burns; Neill K. J. Adhikari; Maureen O. Meade

doi:10.1002/14651858.CD004127

Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados
Respuestas clínicas Cochrane
Guías
Temas

Revisiones y protocolos relacionados

Respuestas clínicas Cochrane

Topics

Temas

Analysis 1.1

Comparison 1 noninvasive versus invasive weaning, Outcome 1 mortality.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.1

Comparison 2 noninvasive versus invasive weaning, Outcome 1 weaning failure.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.1

Comparison 3 noninvasive versus invasive weaning, Outcome 1 nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.1

Comparison 4 noninvasive versus invasive weaning, Outcome 1 LOS ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.1

Comparison 5 noninvasive versus invasive weaning, Outcome 1 LOS hospital.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.1

Comparison 6 noninvasive versus invasive weaning, Outcome 1 average total duration of mechanical ventilatory support.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 7.1

Comparison 7 noninvasive versus invasive weaning, Outcome 1 average duration of ventilation related to weaning.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 8.1

Comparison 8 noninvasive versus invasive weaning, Outcome 1 duration of endotracheal mechanical ventilation.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 9.1

Comparison 9 sensitivity analysis: excluding quasi‐randomized study, Outcome 1 mortality.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 9.2

Comparison 9 sensitivity analysis: excluding quasi‐randomized study, Outcome 2 nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Table 1. Comparison of NPPV and IPPV weaning strategies on outcomes

Outcome	Number of trials	Number of patients	Test of homogeneity	Summary estimate	Significance
Mortality	5	171	p=0.83	RR 0.41 [0.22, 0.76]	p=0.005
VAP	4	150	p=0.27	RR 0.28 [0.09, 0.85]	p=0.03
Weaning failure	3	104	p=0.20	RR 0.82 [0.29, 2.32]	p=0.71
ICU LOS	3	126	p=0.05	WMD ‐6.88 [‐12.60, ‐1.15]	p=0.02
Hospital LOS	3	100	p=0.20	WMD ‐7.33 [‐14.05, ‐0.61]	p=0.03
Total duration MV	2	93	p=0.59	WMD ‐7.33 [‐11.45, ‐3.22]	p=0.0005
Duration related to weaning	3	92	p<0.00001	WMD ‐2.72 [‐15.58, 10.14)	p=0.68
Duration ETMV	3	97	p=0.08	WMD ‐6.32 [‐12.12, ‐0.52]	p=0.03

Table 1. Comparison of NPPV and IPPV weaning strategies on outcomes

Ir a la tabla de la revisión

Comparison 1. noninvasive versus invasive weaning

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 mortality Show forest plot	5	171	Risk Ratio (M‐H, Random, 95% CI)	0.41 [0.22, 0.76]

1.1 COPD	2	74	Risk Ratio (M‐H, Random, 95% CI)	0.25 [0.07, 0.91]
1.2 mixed	3	97	Risk Ratio (M‐H, Random, 95% CI)	0.47 [0.23, 0.96]

Comparison 1. noninvasive versus invasive weaning

Ir a la tabla de la revisión

Comparison 2. noninvasive versus invasive weaning

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 weaning failure Show forest plot	3	104	Risk Ratio (M‐H, Random, 95% CI)	0.82 [0.29, 2.32]

1.1 COPD	1	50	Risk Ratio (M‐H, Random, 95% CI)	0.38 [0.11, 1.25]
1.2 mixed	2	54	Risk Ratio (M‐H, Random, 95% CI)	1.28 [0.45, 3.60]

Comparison 2. noninvasive versus invasive weaning

Ir a la tabla de la revisión

Comparison 3. noninvasive versus invasive weaning

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 nosocomial pneumonia Show forest plot	4	150	Risk Ratio (M‐H, Random, 95% CI)	0.28 [0.09, 0.85]

Comparison 3. noninvasive versus invasive weaning

Ir a la tabla de la revisión

Comparison 4. noninvasive versus invasive weaning

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 LOS ICU Show forest plot	3	126	Mean Difference (IV, Random, 95% CI)	‐6.88 [‐12.60, ‐1.15]

Comparison 4. noninvasive versus invasive weaning

Ir a la tabla de la revisión

Comparison 5. noninvasive versus invasive weaning

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 LOS hospital Show forest plot	3	100	Mean Difference (IV, Random, 95% CI)	‐7.33 [‐14.05, ‐0.61]

Comparison 5. noninvasive versus invasive weaning

Ir a la tabla de la revisión

Comparison 6. noninvasive versus invasive weaning

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 average total duration of mechanical ventilatory support Show forest plot	2	93	Mean Difference (IV, Random, 95% CI)	‐7.33 [‐11.45, ‐3.22]

Comparison 6. noninvasive versus invasive weaning

Ir a la tabla de la revisión

Comparison 7. noninvasive versus invasive weaning

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 average duration of ventilation related to weaning Show forest plot	3	92	Mean Difference (IV, Random, 95% CI)	‐2.72 [‐15.58, 10.14]

Comparison 7. noninvasive versus invasive weaning

Ir a la tabla de la revisión

Comparison 8. noninvasive versus invasive weaning

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 duration of endotracheal mechanical ventilation Show forest plot	3	97	Mean Difference (IV, Random, 95% CI)	‐6.32 [‐12.12, ‐0.52]

Comparison 8. noninvasive versus invasive weaning

Ir a la tabla de la revisión

Comparison 9. sensitivity analysis: excluding quasi‐randomized study

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 mortality Show forest plot	4	147	Risk Ratio (M‐H, Random, 95% CI)	0.43 [0.23, 0.81]

2 nosocomial pneumonia Show forest plot	3	126	Risk Ratio (M‐H, Random, 95% CI)	0.37 [0.15, 0.93]

Comparison 9. sensitivity analysis: excluding quasi‐randomized study

Ir a la tabla de la revisión

The Cochrane Library

Scolaris Language Selector Scolaris Language Selector

Idioma de la Revisión Cochrane

Idioma de la web

Scolaris Content Language Banner Portlet Scolaris Content Language Banner Portlet