Article: Efficacy of Sequential Mechanical Ventilation in Patients with Chronic Obstructive Pulmonary Disease and Respiratory Failure: A Meta-Analysis.
Alternative therapies in health and medicine
2023 , Page(s) 436–443
Abstract: Context: Mechanical ventilation is important in treatment of COPD, and weaning patients from ventilation is a crucial aspect. Medical practitioners have proposed a method of weaning patients using a transition from invasive to noninvasive positive ... ...
| Abstract | Context: Mechanical ventilation is important in treatment of COPD, and weaning patients from ventilation is a crucial aspect. Medical practitioners have proposed a method of weaning patients using a transition from invasive to noninvasive positive pressure ventilation (IPPV to NIPPV). This method is sequential invasive-noninvasive mechanical ventilation (INMV). Objective: The study aimed to determine the efficacy of sequential INMV for COPD patients with respiratory failure. Design: The research team performed a systematic review by searching eight databases, both domestically and overseas: The Cochrane Library, EMbase, Web of Science, PubMed, China Biomedical Literature Database (CBM), VIP Database for Chinese Technical Periodicals (VIP), China National Knowledge Infrastructure (CNKI) and WanFang. The search used the keywords chronic obstructive pulmonary disease, respiratory failure, and mechanical ventilation. Using data from the included studies, the team then performed a meta-analysis. Setting: The study took place at Taizhou People's Hospital in Taizhou, Jiang Su , China. Interventions: The RCTs' intervention groups had received INMV and the control groups had received only IPPV. Outcome measures: The outcome measures were: (1) lengths of hospital stays, (2) duration of mechanical ventilation, (3) duration of IPPV, and (4) incidence of ventilator-associated pneumonia (VAP). The research team used RevMan 5.3 software and conducted data analysis following a thorough assessment of the literature's quality. Results: The meta-analysis included 19 studies, all randomized controlled trials (RCTs). The four outcomes were significantly better for the intervention group than the control group in the 19 RCTs: (1) with shorter lengths of hospital stay-standardized mean difference SMD: -6.98, 95% Cl (-8.60, -5.36), P = .000]; (2) with shorter durations of mechanical ventilation-SMD: -4.77, 95% Cl (-6.69, -2.86), P = .000]; (3) with shorter durations of invasive ventilation-SMD: -7.30, 95% Cl (-8.65, -5.96), P = .000]; and (4) with fewer incidences of VAP-odds ratio, OR: 0.26, 95% Cl (0.20, 0.34), P = .975]. Conclusions: The lengths of hospital stays, durations of mechanical ventilation, durations of invasive ventilation, and incidences of VAP indicate that the sequential mechanical ventilation can be effective for patients with COPD and respiratory failure. However, additional high-quality studies need to confirm these findings. |
|---|---|
| Language | English |
| Publishing date | 2023-07-21 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 1225073-9 |
| ISSN | 1078-6791 |
| ISSN | 1078-6791 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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