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BMC Pulmonary Medicine
Published in: BMC Pulmonary Medicine 1/2016

Open Access 01-12-2016 | Research article

Noninvasive versus invasive mechanical ventilation for immunocompromised patients with acute respiratory failure: a systematic review and meta-analysis

Authors: Tao Wang, Lixi Zhang, Kai Luo, Jianqiang He, Yong Ma, Zongru Li, Na Zhao, Qun Xu, Yi Li, Xuezhong Yu

Published in: BMC Pulmonary Medicine | Issue 1/2016

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Abstract

Background

To determine the effects of noninvasive mechanical ventilation (NIV) compared with invasive mechanical ventilation (IMV) as the initial mechanical ventilation on clinical outcomes when used for treatment of acute respiratory failure (ARF) in immunocompromised patients.

Methods

We searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the Chinese Biomedical Literature Database (CBM) and other databases. Subgroup analyses by disease severity and causes of immunodeficiency were also conducted.

Results

Thirteen observational studies with a total of 2552 patients were included. Compared to IMV, NIV was shown to significantly reduce in-hospital mortality (OR 0.43, 95 % CI 0.23 to 0.80, P value = 0.007) and 30-day mortality (OR 0.34, 95 % CI 0.20 to 0.61, P value < 0.0001) in overall analysis. Subgroup analysis showed NIV had great advantage over IMV for less severe, AIDS, BMT and hematological malignancies patients in reducing mortality and duration of ICU stay.

Conclusions

The overall evidence we obtained shows NIV does more benefits or at least no harm to ARF patients with certain causes of immunodeficiency or who are less severe.
Appendix
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Literature
1.
2.
Linden PK. Approach to the immunocompromised host with infection in the intensive care unit. Infect Dis Clin North Am. 2009;23(3):535–56.CrossRefPubMed
3.
Brochard L, Isabey D, Piquet J, Amaro P, Mancebo J, Messadi AA, Brun-Buisson C, Rauss A, Lemaire F, Harf A. Reversal of acute exacerbations of chronic obstructive lung disease by inspiratory assistance with a face mask. N Engl J Med. 1990;323(22):1523–30.CrossRefPubMed
4.
Boldrini R, Fasano L, Nava S. Noninvasive mechanical ventilation. Curr Opin Crit Care. 2012;18(1):48–53.CrossRefPubMed
5.
Olivieri C, Carenzo L, Vignazia GL, Campanini M, Pirisi M, Della Corte F, et al. Does noninvasive ventilation delivery in the ward provide early effective ventilation? Respir Care. 2015;60(1):6–11.CrossRefPubMed
6.
Antonelli M, Conti G, Rocco M, Bufi M, De Blasi RA, Vivino G, Gasparetto A, Meduri GU. A comparison of noninvasive positive-pressure ventilation and conventional mechanical ventilation in patients with acute respiratory failure. N Engl J Med. 1998;339(7):429–35.CrossRefPubMed
7.
Lightowler JV, Wedzicha JA, Elliott MW, Ram FS. Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis. BMJ (Clinical research ed). 2003;326(7382):185.CrossRef
8.
Lindenauer PK, Stefan MS, Shieh MS, Pekow PS, Rothberg MB, Hill NS. Outcomes associated with invasive and noninvasive ventilation among patients hospitalized with exacerbations of chronic obstructive pulmonary disease. JAMA Intern Med. 2014;174(12):1982–93.CrossRefPubMedPubMedCentral
9.
Plant PK, Owen JL, Elliott MW. Early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease on general respiratory wards: a multicentre randomised controlled trial. Lancet (London, England). 2000;355(9219):1931–5.CrossRef
10.
Vital FM, Ladeira MT, Atallah AN. Non-invasive positive pressure ventilation (CPAP or bilevel NPPV) for cardiogenic pulmonary oedema. Cochrane Database Syst Rev. 2013;5:CD005351.
11.
Keenan SP, Sinuff T, Burns KE, Muscedere J, Kutsogiannis J, Mehta S, et al. Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting. CMAJ. 2011;183(3):E195–214.CrossRefPubMedPubMedCentral
12.
Wang S, Singh B, Tian L, Biehl M, Krastev IL, Kojicic M, Li G. Epidemiology of noninvasive mechanical ventilation in acute respiratory failure--a retrospective population-based study. BMC Emerg Med. 2013;13:6.CrossRefPubMedPubMedCentral
13.
Antonelli M, Conti G, Esquinas A, Montini L, Maggiore SM, Bello G, et al. A multiple-center survey on the use in clinical practice of noninvasive ventilation as a first-line intervention for acute respiratory distress syndrome. Crit Care Med. 2007;35(1):18–25.CrossRefPubMed
14.
Ferrer M, Esquinas A, Leon M, Gonzalez G, Alarcon A, Torres A. Noninvasive ventilation in severe hypoxemic respiratory failure: a randomized clinical trial. Am J Respir Crit Care Med. 2003;168(12):1438–44.CrossRefPubMed
15.
Lemiale V, Mokart D, Resche-Rigon M, Pene F, Mayaux J, Faucher E, et al. Effect of Noninvasive Ventilation vs Oxygen Therapy on Mortality Among Immunocompromised Patients With Acute Respiratory Failure: A Randomized Clinical Trial. JAMA. 2015;314:1711–9.CrossRefPubMed
16.
Bello G, De Pascale G, Antonelli M. Noninvasive ventilation for the immunocompromised patient: always appropriate? Curr Opin Crit Care. 2012;18:54–60.CrossRefPubMed
17.
Gristina GR, Antonelli M, Conti G, Ciarlone A, Rogante S, Rossi C, Bertolini G, GiViTi. Noninvasive versus invasive ventilation for acute respiratory failure in patients with hematologic malignancies: a 5-year multicenter observational survey. Crit Care Med. 2011;39(10):2232–9.CrossRefPubMed
18.
Bach JR, Intintola P, Alba AS, Holland IE. The ventilator-assisted individual. Cost analysis of institutionalization vs rehabilitation and in-home management. Chest. 1992;101(1):26–30.CrossRefPubMed
19.
Nava S, Evangelisti I, Rampulla C, Compagnoni ML, Fracchia C, Rubini F. Human and financial costs of noninvasive mechanical ventilation in patients affected by COPD and acute respiratory failure. Chest. 1997;111(6):1631–8.CrossRefPubMed
20.
Confalonieri M, Calderini E, Terraciano S, Chidini G, Celeste E, Puccio G, Gregoretti C, Meduri GU. Noninvasive ventilation for treating acute respiratory failure in AIDS patients with Pneumocystis carinii pneumonia. Intensive Care Med. 2002;28(9):1233–8.CrossRefPubMed
21.
Le Gall JR, Lemeshow S, Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. Jama. 1993;270(24):2957–63.CrossRefPubMed
22.
23.
24.
25.
GRADEpro Guideline Development Tool [Software]. In: McMaster University, 2015 (developed by Evidence Prime, Inc) Available from: https://​gradepro.​org/​. Accessed 24 July 2016.
26.
Minne L, Abu-Hanna A, de Jonge E. Evaluation of SOFA-based models for predicting mortality in the ICU: A systematic review. Crit Care. 2008;12(6):R161.CrossRefPubMedPubMedCentral
27.
Gachot B, Clair B, Wolff M, Regnier B, Vachon F. Continuous positive airway pressure by face mask or mechanical ventilation in patients with human immunodeficiency virus infection and severe Pneumocystis carinii pneumonia. Intensive Care Med. 1992;18(3):155–9.CrossRefPubMed
28.
Azoulay E, Alberti C, Bornstain C, Leleu G, Moreau D, Recher C, Chevret S, Le Gall JR, Brochard L, Schlemmer B. Improved survival in cancer patients requiring mechanical ventilatory support: impact of noninvasive mechanical ventilatory support. Crit Care Med. 2001;29(3):519–25.CrossRefPubMed
29.
Azoulay E, Fieux F, Moreau D, Thiery G, Rousselot P, Parrot A, Le Gall JR, Dombret H, Schlemmer B. Acute monocytic leukemia presenting as acute respiratory failure. Am J Respir Crit Care Med. 2003;167(10):1329–33.CrossRefPubMed
30.
Azoulay E, Thiery G, Chevret S, Moreau D, Darmon M, Bergeron A, Yang K, Meignin V, Ciroldi M, Le Gall JR, et al. The prognosis of acute respiratory failure in critically ill cancer patients. Medicine. 2004;83(6):360–70.CrossRefPubMed
31.
Depuydt PO, Benoit DD, Vandewoude KH, Decruyenaere JM, Colardyn FA. Outcome in noninvasively and invasively ventilated hematologic patients with acute respiratory failure. Chest. 2004;126(4):1299–306.CrossRefPubMed
32.
Rabitsch W, Staudinger T, Locker GJ, Kostler WJ, Laczika K, Frass M, Knoebl P, Greinix HT, Kalhs P, Keil F. Respiratory failure after stem cell transplantation: improved outcome with non-invasive ventilation. Leuk Lymphoma. 2005;46(8):1151–7.CrossRefPubMed
33.
Pancera CF, Hayashi M, Fregnani JH, Negri EM, Deheinzelin D, de Camargo B. Noninvasive ventilation in immunocompromised pediatric patients: eight years of experience in a pediatric oncology intensive care unit. J Pediatr Hematol Oncol. 2008;30(7):533–8.CrossRefPubMed
34.
Depuydt PO, Benoit DD, Roosens CD, Offner FC, Noens LA, Decruyenaere JM. The impact of the initial ventilatory strategy on survival in hematological patients with acute hypoxemic respiratory failure. J Crit Care. 2010;25(1):30–6.CrossRefPubMed
35.
Molina R, Bernal T, Borges M, Zaragoza R, Bonastre J, Granada RM, Rodriguez-Borregan JC, Nunez K, Seijas I, Ayestaran I, et al. Ventilatory support in critically ill hematology patients with respiratory failure. Crit Care. 2012;16(4):R133.CrossRefPubMedPubMedCentral
36.
Belenguer-Muncharaz A, Albert-Rodrigo L, Ferrandiz-Selles A, Cebrian-Graullera G. Ten-year evolution of mechanical ventilation in acute respiratory failure in the hematogical patient admitted to the intensive care unit. Med Intensiva. 2013;37(7):452–60.CrossRefPubMed
37.
Turkoglu M, Erdem GU, Suyani E, Sancar ME, Yalcin MM, Aygencel G, Aki Z, Sucak G. Acute respiratory distress syndrome in patients with hematological malignancies. Hematology. 2013;18(3):123–30.CrossRefPubMed
38.
Adda M, Coquet I, Darmon M, Thiery G, Schlemmer B, Azoulay E. Predictors of noninvasive ventilation failure in patients with hematologic malignancy and acute respiratory failure. Crit Care Med. 2008;36(10):2766–72.CrossRefPubMed
39.
Chin K, Uemoto S, Takahashi K, Egawa H, Kasahara M, Fujimoto Y, et al. Noninvasive ventilation for pediatric patients including those under 1-year-old undergoing liver transplantation. Liver Transpl. 2005;11:188–95.CrossRefPubMed
40.
Hilbert G, Gruson D, Vargas F, Valentino R, Chene G, Boiron JM, Pigneux A, Reiffers J, Gbikpi-Benissan G, Cardinaud JP. Noninvasive continuous positive airway pressure in neutropenic patients with acute respiratory failure requiring intensive care unit admission. Crit Care Med. 2000;28(9):3185–90.CrossRefPubMed
41.
Hilbert G, Gruson D, Vargas F, Valentino R, Gbikpi-Benissan G, Dupon M, Reiffers J, Cardinaud JP. Noninvasive ventilation in immunosuppressed patients with pulmonary infiltrates, fever, and acute respiratory failure. N Engl J Med. 2001;344(7):481–7.CrossRefPubMed
42.
Piastra M, De Luca D, Pietrini D, Pulitano S, D’Arrigo S, Mancino A, Conti G. Noninvasive pressure-support ventilation in immunocompromised children with ARDS: a feasibility study. Intensive Care Med. 2009;35(8):1420–7.CrossRefPubMed
43.
Rocco M, Conti G, Antonelli M, Bufi M, Costa MG, Alampi D, Ruberto F, Stazi GV, Pietropaoli P. Non-invasive pressure support ventilation in patients with acute respiratory failure after bilateral lung transplantation. Intensive Care Med. 2001;27(10):1622–6.CrossRefPubMed
44.
Yu H, Ping G, Zhengxian C. Noninvasive versus invasive mechanical ventilation in severe pneumonia patients after kidney transplant. J Pract Med. 2009;18:3108–9.
45.
Festic E, Gajic O, Limper AH, Aksamit TR. Acute respiratory failure due to pneumocystis pneumonia in patients without human immunodeficiency virus infection: outcome and associated features. Chest. 2005;128:573–9.CrossRefPubMed
46.
Schnell D, Timsit JF, Darmon M, Vesin A, Goldgran-Toledano D, Dumenil AS, et al. Noninvasive mechanical ventilation in acute respiratory failure: trends in use and outcomes. Intensive Care Med. 2014;40:582–91.CrossRefPubMed
47.
Grgic Medic M, Gornik I, Gasparovic V. Hematologic malignancies in the medical intensive care unit--Outcomes and prognostic factors. Hematology (Amsterdam, Netherlands). 2015;20(5):247–53.
48.
Rabbat A, Chaoui D, Montani D, Legrand O, Lefebvre A, Rio B, Roche N, Lorut C, Marie JP, Huchon G. Prognosis of patients with acute myeloid leukaemia admitted to intensive care. Br J Haematol. 2005;129(3):350–7.CrossRefPubMed
49.
Azevedo LC, Caruso P, Silva UV, Torelly AP, Silva E, Rezende E, Netto JJ, Piras C, Lobo SM, Knibel MF, et al. Outcomes for patients with cancer admitted to the ICU requiring ventilatory support: results from a prospective multicenter study. Chest. 2014;146(2):257–66.CrossRefPubMed
50.
Johnson CS, Frei CR, Metersky ML, Anzueto AR, Mortensen EM. Non-invasive mechanical ventilation and mortality in elderly immunocompromised patients hospitalized with pneumonia: a retrospective cohort study. BMC Pulm Med. 2014;14:7.CrossRefPubMedPubMedCentral
51.
52.
Namendys-Silva SA, Hernandez-Garay M, Herrera-Gomez A. Noninvasive ventilation in immunosuppressed patients. Am J Hosp Palliat Care. 2010;27(2):134–8.CrossRefPubMed
53.
Vitacca M, Ambrosino N, Clini E, Porta R, Rampulla C, Lanini B, et al. Physiological response to pressure support ventilation delivered before and after extubation in patients not capable of totally spontaneous autonomous breathing. Am J Respir Crit Care Med. 2001;164(4):638–41.CrossRefPubMed
54.
Schonhofer B, Kuhlen R, Neumann P, Westhoff M, Berndt C, Sitter H. Clinical practice guideline: non-invasive mechanical ventilation as treatment of acute respiratory failure. Deutsches Arzteblatt Int. 2008;105(24):424–33.
55.
Antonelli M, Conti G, Bufi M, Costa MG, Lappa A, Rocco M, Gasparetto A, Meduri GU. Noninvasive ventilation for treatment of acute respiratory failure in patients undergoing solid organ transplantation: a randomized trial. Jama. 2000;283(2):235–41.CrossRefPubMed
56.
Barbas CS, Serpa Neto A. New puzzles for the use of non-invasive ventilation for immunosuppressed patients. J Thorac Dis. 2016;8(1):E100–3.PubMedPubMedCentral
57.
Amado-Rodriguez L, Bernal T, Lopez-Alonso I, Blazquez-Prieto J, Garcia-Prieto E, Albaiceta GM. Impact of Initial Ventilatory Strategy in Hematological Patients With Acute Respiratory Failure: A Systematic Review and Meta-Analysis. Crit Care Med. 2016;44(7):1406–1413.
58.
Nava S, Hill N. Non-invasive ventilation in acute respiratory failure. Lancet (London, England). 2009;374(9685):250–9.CrossRef
59.
Quintin L. Cut-off point for switching from non- -invasive ventilation to intubation in severe ARDS. Fifty shades of grey? Anaesthesiol Intensive Ther. 2016;48(1):62–4.CrossRefPubMed
Metadata
Title
Noninvasive versus invasive mechanical ventilation for immunocompromised patients with acute respiratory failure: a systematic review and meta-analysis
Authors
Tao Wang
Lixi Zhang
Kai Luo
Jianqiang He
Yong Ma
Zongru Li
Na Zhao
Qun Xu
Yi Li
Xuezhong Yu
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2016
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-016-0289-y

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