دورية أكاديمية
Home respiratory strategies in COPD patients with chronic hypercapnic respiratory failure: a systematic review and network meta-analysis.
| العنوان: | Home respiratory strategies in COPD patients with chronic hypercapnic respiratory failure: a systematic review and network meta-analysis. |
|---|---|
| المؤلفون: | Pitre T; Department of Respirology, University of Toronto, Toronto, ON., Abbasi S; Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON., Kachkovski GV; Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON., Burns L; Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON., Huan P; Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON., Mah J; Department of Medicine, Dalhousie University, Halifax, NS., Crimi C; Respiratory Medicine Unit, Policlinico 'G. Rodolico-San Marco' University Hospital, Catania, Italy., Cortegiani A; Department of Surgical Oncological and Oral Science (Di.Chir.On.S.). University of Palermo, Italy.; Department of Anesthesia, Intensive Care and Emergency, University Hospital Policlinico 'Paolo Giaccone', Palermo, Italy., Rochwerg B; Department of Medicine, McMaster University, Hamilton, ON.; Health Research Methods Evidence and Impact, McMaster University, Hamilton, ON., Zeraatkar D; Health Research Methods Evidence and Impact, McMaster University, Hamilton, ON. zeraatd@mcmaster.ca.; Department of Anesthesiology, McMaster University, Hamilton, ON. |
| المصدر: | Respiratory care [Respir Care] 2024 Apr 03. Date of Electronic Publication: 2024 Apr 03. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Daedalus Enterprises for the American Association for Respiratory Therapy Country of Publication: United States NLM ID: 7510357 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1943-3654 (Electronic) Linking ISSN: 00201324 NLM ISO Abbreviation: Respir Care Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <1983-> : Dallas, TX : Daedalus Enterprises for the American Association for Respiratory Therapy Original Publication: Philadelphia : Lippincott, c1971- |
| مستخلص: | Background: Home non-invasive positive pressure ventilation (NPPV) may improve chronic hypercarbia in COPD and patient important outcomes. The efficacy of home high flow nasal cannula (HFNC) as an alternative is unclear. Methods: We searched MEDLINE, EMBASE, Cochrane CENTRAL, SCOPUS, and Clinicaltrials.gov for randomized trials of patients from inception to March 31 st and updated the search on July 14, 2023. We performed a frequentist network meta-analysis and assessed the certainty of the evidence using the GRADE approach. We analyzed randomized trials (RCTs) comparing NPPV, HFNC, or standard care in adult COPD patients with chronic hypercapnic respiratory failure. Outcomes included mortality, COPD exacerbations, hospitalizations, and quality of life (SGRQ). Results: We analyzed twenty-four RCTs (1850 patients). We found that NPPV may reduce death risk compared to standard care (relative risk [RR] 0.82 [95% CI 0.66 to 1.00]) and probably reduces acute exacerbations (RR 0.71 [95% CI 0.58 to 0.87]). HFNC probably reduces acute exacerbations compared to standard care (RR 0.77 [0.68 to 0.88]) but its effect on mortality is uncertain (RR 1.20 [95% CI 0.63 to 2.28]). HFNC probably improves SGRQ scores (mean difference [MD] -7.01 [95% CI -12.27 to -1.77]) and may reduce hospitalizations (RR 0.87 [0.69 to 1.09]) compared to standard care. No significant difference was observed between HFNC and NPPV in reducing exacerbations. Conclusion: Both NPPV and HFNC reduce exacerbation risks in COPD patients compared to standard care. HFNC may offer advantages in improving quality of life. (Copyright © 2024 by Daedalus Enterprises.) |
| فهرسة مساهمة: | Keywords: COPD; HFNC; NPPV; network meta-analysis |
| تواريخ الأحداث: | Date Created: 20240403 Latest Revision: 20240403 |
| رمز التحديث: | 20240404 |
| DOI: | 10.4187/respcare.11805 |
| PMID: | 38569922 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1943-3654 |
|---|---|
| DOI: | 10.4187/respcare.11805 |