Efficacy of noninvasive ventilation after planned extubation: A systematic review and meta-analysis of randomized controlled trials

Abstract The objective our meta-analysis is to update the evidence on the efficacy of noninvasive ventilation (NIV) compared with conventional oxygen therapy after planned extubation. We did a systematic literature review of database, including Pubmed, EMBASE, and Cochrane. We included randomized co...

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Bibliographic Details
Published in:Heart & lung 2015-03, Vol.44 (2), p.150-157
Main Authors: Bajaj, Anurag, MD, Rathor, Parul, MBBS, Sehgal, Vishal, MD, Shetty, Ajay, MD
Format: Article
Language:English
Subjects:
Airway Extubation
Cardiovascular
Chronic obstructive pulmonary disease
Clinical trials
Critical Care
Extubation
Humans
Intensive care
Intubation, Intratracheal
Mechanical ventilation
Meta-analysis
Noninvasive ventilation
Noninvasive Ventilation - methods
Oxygen Inhalation Therapy - methods
Oxygen therapy
Pulmonary Disease, Chronic Obstructive - therapy
Pulmonary/Respiratory
Randomized controlled trial
Randomized Controlled Trials as Topic
Reintubation
Systematic review
Ventilation
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Summary:Abstract The objective our meta-analysis is to update the evidence on the efficacy of noninvasive ventilation (NIV) compared with conventional oxygen therapy after planned extubation. We did a systematic literature review of database, including Pubmed, EMBASE, and Cochrane. We included randomized controlled trials comparing NIV with conventional oxygen therapy after planned extubation in medical intensive care unit (ICU) in our analysis. The results of our meta-analysis is consistent with the results of previous reviews and show that NIV decreased reintubation rate significantly as compared to conventional oxygen therapy in chronic obstructive pulmonary disease (COPD) and patients at high risk for extubation failure; COPD (RR, 0.33; 95% CI, 0.16–0.69; I2 = 0), high risk (RR, 0.47; 95% CI, 0.32–0.70; I2 = 0). However, in a mixed medical ICU population, there was no statistical difference of reintubation rate between the two groups (RR, 0.66; 95% CI, 0.25–1.73; I2 = 68%). Our study suggests that use of NIV after planned extubation significantly decreases the reintubation rate in COPD patients and patients at high risk for extubation failure, confirming the findings of previous reviews. There is no difference in the reintubation rate between the two groups in the mixed medical ICU population.
ISSN:0147-9563
1527-3288
DOI:10.1016/j.hrtlng.2014.12.002