scholarly journals Use of non-invasive ventilation to wean critically ill adults off invasive ventilation: meta-analysis and systematic review

BMJ ◽  
2009 ◽  
Vol 338 (may21 1) ◽  
pp. b1574-b1574 ◽  
Author(s):  
K. E A Burns ◽  
N. K J Adhikari ◽  
S. P Keenan ◽  
M. Meade
Keyword(s):  
Systematic Review ◽  
Critically Ill ◽  
Meta Analysis ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Critically Ill Adults ◽  
Ill Adults

Non-invasive ventilation versus invasive weaning in critically ill adults: a systematic review and meta-analysis

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2021-216993
Author(s):  
Karen E A Burns ◽  
James Stevenson ◽  
Matthew Laird ◽  
Neill K J Adhikari ◽  
Yuchong Li ◽  
...  
Keyword(s):  
Critically Ill ◽  
Total Duration ◽  
Cochrane Central Register ◽  
Invasive Ventilation ◽  
High Quality ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Critically Ill Adults ◽  
Ill Adults ◽  
Duration Of Ventilation

BackgroundExtubation to non-invasive ventilation (NIV) has been investigated as a strategy to wean critically ill adults from invasive ventilation and reduce ventilator-related complications.MethodsWe searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, proceedings of four conferences and bibliographies (to June 2020) for randomised and quasi-randomised trials that compared extubation with immediate application of NIV to continued invasive weaning in intubated adults and reported mortality (primary outcome) or other outcomes. Two reviewers independently screened citations, assessed trial quality and abstracted data.ResultsWe identified 28 trials, of moderate-to-good quality, involving 2066 patients, 44.6% with chronic obstructive pulmonary disease (COPD). Non-invasive weaning significantly reduced mortality (risk ratio (RR) 0.57, 95% CI 0.44 to 0.74; high quality), weaning failures (RR 0.59, 95% CI 0.43 to 0.81; high quality), pneumonia (RR 0.30, 95% CI 0.22 to 0.41; high quality), intensive care unit (ICU) (mean difference (MD) −4.62 days, 95% CI −5.91 to −3.34) and hospital stay (MD −6.29 days, 95% CI −8.90 to −3.68). Non-invasive weaning also significantly reduced the total duration of ventilation, duration of invasive ventilation and duration of ventilation related to weaning (MD −0.57, 95% CI −1.08 to −0.07) and tracheostomy rate. Mortality, pneumonia, reintubation and ICU stay were significantly lower in trials enrolling COPD (vs mixed) populations.ConclusionNon-invasive weaning significantly reduced mortality, pneumonia and the duration of ventilation related to weaning, particularly in patients with COPD. Beneficial effects are less clear (or more careful patient selection is required) in non-COPD patients.PROSPERO registration numberCRD42020201402.

Endogenous IgG hypogammaglobulinaemia in critically ill adults with sepsis: systematic review and meta-analysis

2015 ◽  
Vol 41 (8) ◽  
pp. 1393-1401 ◽  
Author(s):  
Manu Shankar-Hari ◽  
Nicholas Culshaw ◽  
Benjamin Post ◽  
Eduardo Tamayo ◽  
David Andaluz-Ojeda ◽  
...  
Keyword(s):  
Systematic Review ◽  
Critically Ill ◽  
Meta Analysis ◽  
Critically Ill Adults ◽  
Ill Adults
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