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Open Access 01-12-2017 | Research

Use of noninvasive ventilation in immunocompromised patients with acute respiratory failure: a systematic review and meta-analysis

Authors: Hui-Bin Huang, Biao Xu, Guang-Yun Liu, Jian-Dong Lin, Bin Du

Published in: Critical Care | Issue 1/2017

Abstract

Background

Acute respiratory failure (ARF) remains a common hazardous complication in immunocompromised patients and is associated with increased mortality rates when endotracheal intubation is needed. We aimed to evaluate the effect of early noninvasive ventilation (NIV) compared with oxygen therapy alone in this patient population.

Methods

We searched for relevant studies in MEDLINE, EMBASE, and the Cochrane database up to 25 July 2016. Randomized controlled trials (RCTs) were included if they reported data on any of the predefined outcomes in immunocompromised patients managed with NIV or oxygen therapy alone. Results were expressed as risk ratio (RR) and mean difference (MD) with accompanying 95% confidence interval (CI).

Results

Five RCTs with 592 patients were included. Early NIV significantly reduced short-term mortality (RR 0.62, 95% CI 0.40 to 0.97, p = 0.04) and intubation rate (RR 0.52, 95% CI 0.32 to 0.85, p = 0.01) when compared with oxygen therapy alone, with significant heterogeneity in these two outcomes between the pooled studies. In addition, early NIV was associated with a shorter length of ICU stay (MD −1.71 days, 95% CI −2.98 to 1.44, p = 0.008) but not long-term mortality (RR 0.92, 95% CI 0.74 to 1.15, p = 0.46).

Conclusions

The limited evidence indicates that early use of NIV could reduce short-term mortality in selected immunocompromised patients with ARF. Further studies are needed to identify in which selected patients NIV could be more beneficial, before wider application of this ventilator strategy.

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Title: Use of noninvasive ventilation in immunocompromised patients with acute respiratory failure: a systematic review and meta-analysis
Authors: Hui-Bin Huang
Biao Xu
Guang-Yun Liu
Jian-Dong Lin
Bin Du
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Critical Care / Issue 1/2017
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-016-1586-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Use of noninvasive ventilation in immunocompromised patients with acute respiratory failure: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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