TY - JOUR
T1 - Effects of non-invasive ventilation on reintubation rate
T2 - A systematic review and meta-analysis of randomised studies of patients undergoing cardiothoracic surgery
AU - Olper, Luigi
AU - Corbetta, Davide
AU - Cabrini, Luca
AU - Landoni, Giovanni
AU - Zangrillo, Alberto
PY - 2013
Y1 - 2013
N2 - Objective: To estimate the effect of non-invasive mechanical ventilation (NIV) on the rate of reintubation among patients undergoing cardiothoracic surgery. Design: A meta-analysis of randomised trials. Data sources: Medline, Embase, and the Cochrane Central Register of clinical trials were searched (April 2012) for pertinent studies by two trained investigators. International experts were contacted. Data extraction: Articles were assessed by two trained investigators, with divergences resolved by consensus. Inclusion criterion was random allocation to NIV versus standard treatment without restrictions on duration or modalities of the treatment delivered. Data synthesis: Fourteen studies enrolling 1211 patients were included in the meta-analysis. NIV reduced the reintubation rate (risk ratio [RR], 0.29; 95% CI, 0.16-0.53; P for efficacy <0.0001; I2 = 0), hospital length of stay and mortality. Subgroup analyses suggested that the benefits of NIV are more important in patients with ongoing acute respiratory failure (RR, 0.25; 95% CI, 0.07-0.89) and in those at high risk of developing postoperative pulmonary complications (RR, 0.19; 95% CI, 0.04-0.84). Analyses including prophylactic studies in patients at low risk did not show a significant effect of NIV on reintubation rate (RR = 0.42; 95% CI, 0.12-1.48) and on any of the outcomes considered except for oxygenation. Conclusions: NIV seems to be effective in reducing reintubation rate after cardiothoracic surgery. The results of this meta-analysis should be confirmed by large randomised controlled studies.
AB - Objective: To estimate the effect of non-invasive mechanical ventilation (NIV) on the rate of reintubation among patients undergoing cardiothoracic surgery. Design: A meta-analysis of randomised trials. Data sources: Medline, Embase, and the Cochrane Central Register of clinical trials were searched (April 2012) for pertinent studies by two trained investigators. International experts were contacted. Data extraction: Articles were assessed by two trained investigators, with divergences resolved by consensus. Inclusion criterion was random allocation to NIV versus standard treatment without restrictions on duration or modalities of the treatment delivered. Data synthesis: Fourteen studies enrolling 1211 patients were included in the meta-analysis. NIV reduced the reintubation rate (risk ratio [RR], 0.29; 95% CI, 0.16-0.53; P for efficacy <0.0001; I2 = 0), hospital length of stay and mortality. Subgroup analyses suggested that the benefits of NIV are more important in patients with ongoing acute respiratory failure (RR, 0.25; 95% CI, 0.07-0.89) and in those at high risk of developing postoperative pulmonary complications (RR, 0.19; 95% CI, 0.04-0.84). Analyses including prophylactic studies in patients at low risk did not show a significant effect of NIV on reintubation rate (RR = 0.42; 95% CI, 0.12-1.48) and on any of the outcomes considered except for oxygenation. Conclusions: NIV seems to be effective in reducing reintubation rate after cardiothoracic surgery. The results of this meta-analysis should be confirmed by large randomised controlled studies.
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M3 - Article
C2 - 23944209
AN - SCOPUS:84887561251
VL - 15
SP - 220
EP - 227
JO - Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine.
JF - Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine.
SN - 1441-2772
IS - 3
ER -