A meta-analysis on treatment effect of sequential noninvasive following invasive mechanical ventilation in chronic obstructive pulmonary disease patients with respiratory failure_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

YANG Lin ^1,2 , YAO Li ^1,2 ,  ZHANG Zhigang ^1,2 , DING Nannan ^1,2 , ZHANG Caiyun ² , YANG Liping ² , YUE Weigang ² , LI Na ^1,2 , TIAN Jinhui ³

1. School of Nursing, Lanzhou University, Lanzhou, Gansu 730000, P. R. China;
2. The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P. R. China;
3. Evidence-based Medicine Center, Lanzhou University, Lanzhou, Gansu 730000, P. R. China;

Corresponding?author：

ZHANG Zhigang, Email: zzg3444@163.com

Keywords：

Mechanical ventilation; Sequential ventilation; Chronic obstructive pulmonary disease; Respiratory failure; Meta-analysis

DOI：

10.7507/1671-6205.201903008

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the treatment effect of sequential noninvasive following invasive mechanical ventilation in chronic obstructive pulmonary disease (COPD) patients with respiratory failure.Methods A review of randomized controlled trials with meta-analysis performed by searching databases of PubMed, the Cochrane Library, Embase, Chinese BioMedical Literature Database, China National Knowledge Infrastructure, and WanFang data. Randomized controlled trials by using sequential noninvasive following invasive mechanical ventilation in COPD patients with respiratory failure were eligible for inclusion.Results Eleven trials were included, involving 553 COPD patients with respiratory failure. Meta-analysis showed that sequential noninvasive following invasive mechanical ventilation reduced the mortality rate [RR=0.37, 95%CI(0.22 to 0.61), P=0.000 1], the incidence of ventilator-associated pneumonia (VAP) [RR=0.20, 95%CI(0.13 to 0.32), P<0.000 01], reintubation rate [RR=0.40, 95%CI(0.23 to 0.68), P=0.0008]; it also decreased the duration of invasive mechanical ventilation [MD=–10.47, 95%CI(–13.80 to –7.14), P<0.000 01] and duration of mechanical ventilation [MD=–4.54, 95%CI(–7.01 to –2.06), P=0.000 3], which also shortened the lengths of stay in an intensive care unit (ICU) [MD=–8.75, 95%CI(–13.49 to –4.01), P=0.000 3], as well as length of hospital stay [MD=–9.11, 95%CI(–11.68 to –6.55), P<0.000 01］.Conclusion Sequential noninvasive following invasive mechanical ventilation can significantly reduce the incidence of VAP, the duration of invasive mechanical ventilation, the length of hospital stay in COPD patients with respiratory failure, and reduce the mortality, reintubation rate, the duration of mechanical ventilation and the length of ICU stay as well.

Citation： YANG Lin, YAO Li, ZHANG Zhigang, DING Nannan, ZHANG Caiyun, YANG Liping, YUE Weigang, LI Na, TIAN Jinhui. A meta-analysis on treatment effect of sequential noninvasive following invasive mechanical ventilation in chronic obstructive pulmonary disease patients with respiratory failure. Chinese Journal of Respiratory and Critical Care Medicine, 2020, 19(4): 351-358. doi: 10.7507/1671-6205.201903008 Copy

1.	Lv Y, Lv Q, Lv Q, et al. Pulmonary infection control window as a switching point for sequential ventilation in the treatment of COPD patients: a meta-analysis. Int J Chron Obstruct Pulmon Dis, 2017, 12: 1255-1267.
2.	蔡柏薔. 慢性阻塞性肺疾病急性加重(AECOPD)診治中國專家共識(草案). 中華哮喘雜志(電子版), 2013, 7(1): 1-13.
3.	鄒石海, 周銳, 陳平, 等. 以肺部感染控制窗為切換點進行有創-無創序貫治療在 COPD 呼吸衰竭中的應用. 中南大學學報(醫學版), 2006, 31(1): 120-124.
4.	趙志國. 有創–無創序貫通氣療法治療慢性阻塞性肺疾病引發的嚴重呼吸衰竭的臨床研究. 信息醫學, 2018, 31(11): 110-112.
5.	袁順蓉, 劉南伶, 楊三春, 等. 有創無創序貫機械通氣治療慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的臨床研究. 西部醫學, 2014, 26(9): 1176-1178.
6.	鄭瑞強, 劉玲, 楊毅, 等. 有創無創序貫機械通氣治療慢性阻塞性肺病所致急性呼吸衰竭的研究. 中華急診醫學雜志, 2005, 14(1): 21-25.
7.	賀文成, 鄭志剛. 經鼻高流量氧療應用于 COPD 致呼吸衰竭的序貫機械通氣. 江西醫藥, 2018, 53(5): 460-463.
8.	Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions. Version 5.1.0. London: The Cochrane Collaboration, 2011.
9.	Wang C. Pulmonary infection control window in treatment of severe respiratory failure of chronic obstructive pulmonary diseases: a prospective, randomized controlled, multi-centred study. Chin Med J (Engl), 2005, 118(19): 1589-1594.
10.	Nava S, Ambrosino N, Clini E, et al. Noninvasive mechanical ventilation in the weaning of patients with respiratory failure due to chronic obstructive pulmonary disease: a randomized, controlled trial. Ann Intern Med, 1998, 128(9): 721-728.
11.	Wang C, Shang M, Huang K, et al. Sequential non-invasive mechanical ventilation following short-term invasive mechanical ventilation in COPD induced hypercapnic respiratory failure. Chin Med J (Engl), 2003, 116(1): 39-43.
12.	Prasad SBN, Chaudhry D, Khanna R. Role of noninvasive ventilation in weaning from mechanical ventilation in patients of chronic obstructive pulmonary disease: an Indian experience. Indian J Crit Care Med, 2009, 13(4): 207-221.
13.	陳杰, 邱東華, 陶德瑩, 等. 慢性阻塞性肺疾病急性呼吸衰竭患者從有創過渡到無創機械通氣的時機探討. 中華結核和呼吸雜志, 2001, 24(2): 99-100.
14.	崔恩海, 邱東華, 陳杰, 等. 短期有創序貫無創面罩機械通氣在慢性阻塞性肺疾病危重呼吸衰竭治療中的應用. 中國急救醫學, 2001, 21(11): 640-642.
15.	瞿云中, 唐湘林, 陳平. 無創–有創–無創序貫機械通氣在慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭中的應用及護理監測. 中國全科醫學, 2009, 12(5B): 830-833.
16.	王銀娥, 徐云俠, 陳蓮芳. 序貫機械通氣治療慢性阻塞性肺疾病并發呼吸衰竭病人的護理. 護理研究, 2008, 22(3): 688-690.
17.	龍勝澤, 秦志強, 胡克, 等. 以呼吸泵衰竭改善為切換點序貫通氣治療慢性阻塞性肺疾病呼吸衰竭的研究. 中國呼吸與危重監護雜志, 2007, 6(6): 428-432.
18.	曹林發. 慢性阻塞性肺疾病并發呼吸衰竭相關危險因素分析. 江西醫藥, 2010, 45(2): 129-131.
19.	曾凡鵬, 陳錦河, 陳冬蓮, 等. 序貫性機械通氣治療 COPD 并呼吸衰竭切換時點的隨機對照研究. 中國醫學創新, 2014, 11(12): 51-54.
20.	曾海文. 有創后序貫無創機械通氣治療慢性阻塞性肺疾病合并嚴重呼吸衰竭的臨床分析. 中外醫學研究, 2016, 14(28): 37-38.
21.	劉科. 有創–無創機械通氣序貫治療慢性阻塞性肺疾病合并呼吸衰竭療效觀察. 基層醫學論壇, 2018, 22(7): 904-905.
22.	顧小雷. 有創–無創機械通氣序貫治療慢性阻塞性肺疾病并呼吸衰竭臨床觀察. 中外醫學研究, 2019, 17(3): 30-31.
23.	沈艷, 沈雁波. 肺部感染控制窗和自主呼吸試驗在指導慢性阻塞性肺疾病急性發作機械通氣患者脫機時機的應用. 江蘇醫藥, 2015, 41(18): 2154-2156.
24.	符繼榮, 張志強, 劉大東. 不同切換點在慢性阻塞性肺疾病合并呼吸衰竭患者序貫通氣中的應用研究. 中華臨床醫師雜志(電子版), 2016, 10(11): 1648-1651.
25.	Li PJ, Wang T, Xiao J. Efficacy of two noninvasive weaning strategies in intubated patients with chronic obstructive pulmonary disease: a meta-analysis and indirect treatment comparison. Heart Lung, 2016, 45(2): 132-139.
26.	張靜, 楊陽, 鄒俊. 肺部感染控制窗和自主呼吸試驗在無創正壓通氣序貫治療時機選擇中的運用. 護士進修雜志, 2015, 30(5): 446-448.

1. Lv Y, Lv Q, Lv Q, et al. Pulmonary infection control window as a switching point for sequential ventilation in the treatment of COPD patients: a meta-analysis. Int J Chron Obstruct Pulmon Dis, 2017, 12: 1255-1267.
2. 蔡柏薔. 慢性阻塞性肺疾病急性加重(AECOPD)診治中國專家共識(草案). 中華哮喘雜志(電子版), 2013, 7(1): 1-13.
3. 鄒石海, 周銳, 陳平, 等. 以肺部感染控制窗為切換點進行有創-無創序貫治療在 COPD 呼吸衰竭中的應用. 中南大學學報(醫學版), 2006, 31(1): 120-124.
4. 趙志國. 有創–無創序貫通氣療法治療慢性阻塞性肺疾病引發的嚴重呼吸衰竭的臨床研究. 信息醫學, 2018, 31(11): 110-112.
5. 袁順蓉, 劉南伶, 楊三春, 等. 有創無創序貫機械通氣治療慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的臨床研究. 西部醫學, 2014, 26(9): 1176-1178.
6. 鄭瑞強, 劉玲, 楊毅, 等. 有創無創序貫機械通氣治療慢性阻塞性肺病所致急性呼吸衰竭的研究. 中華急診醫學雜志, 2005, 14(1): 21-25.
7. 賀文成, 鄭志剛. 經鼻高流量氧療應用于 COPD 致呼吸衰竭的序貫機械通氣. 江西醫藥, 2018, 53(5): 460-463.
8. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions. Version 5.1.0. London: The Cochrane Collaboration, 2011.
9. Wang C. Pulmonary infection control window in treatment of severe respiratory failure of chronic obstructive pulmonary diseases: a prospective, randomized controlled, multi-centred study. Chin Med J (Engl), 2005, 118(19): 1589-1594.
10. Nava S, Ambrosino N, Clini E, et al. Noninvasive mechanical ventilation in the weaning of patients with respiratory failure due to chronic obstructive pulmonary disease: a randomized, controlled trial. Ann Intern Med, 1998, 128(9): 721-728.
11. Wang C, Shang M, Huang K, et al. Sequential non-invasive mechanical ventilation following short-term invasive mechanical ventilation in COPD induced hypercapnic respiratory failure. Chin Med J (Engl), 2003, 116(1): 39-43.
12. Prasad SBN, Chaudhry D, Khanna R. Role of noninvasive ventilation in weaning from mechanical ventilation in patients of chronic obstructive pulmonary disease: an Indian experience. Indian J Crit Care Med, 2009, 13(4): 207-221.
13. 陳杰, 邱東華, 陶德瑩, 等. 慢性阻塞性肺疾病急性呼吸衰竭患者從有創過渡到無創機械通氣的時機探討. 中華結核和呼吸雜志, 2001, 24(2): 99-100.
14. 崔恩海, 邱東華, 陳杰, 等. 短期有創序貫無創面罩機械通氣在慢性阻塞性肺疾病危重呼吸衰竭治療中的應用. 中國急救醫學, 2001, 21(11): 640-642.
15. 瞿云中, 唐湘林, 陳平. 無創–有創–無創序貫機械通氣在慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭中的應用及護理監測. 中國全科醫學, 2009, 12(5B): 830-833.
16. 王銀娥, 徐云俠, 陳蓮芳. 序貫機械通氣治療慢性阻塞性肺疾病并發呼吸衰竭病人的護理. 護理研究, 2008, 22(3): 688-690.
17. 龍勝澤, 秦志強, 胡克, 等. 以呼吸泵衰竭改善為切換點序貫通氣治療慢性阻塞性肺疾病呼吸衰竭的研究. 中國呼吸與危重監護雜志, 2007, 6(6): 428-432.
18. 曹林發. 慢性阻塞性肺疾病并發呼吸衰竭相關危險因素分析. 江西醫藥, 2010, 45(2): 129-131.
19. 曾凡鵬, 陳錦河, 陳冬蓮, 等. 序貫性機械通氣治療 COPD 并呼吸衰竭切換時點的隨機對照研究. 中國醫學創新, 2014, 11(12): 51-54.
20. 曾海文. 有創后序貫無創機械通氣治療慢性阻塞性肺疾病合并嚴重呼吸衰竭的臨床分析. 中外醫學研究, 2016, 14(28): 37-38.
21. 劉科. 有創–無創機械通氣序貫治療慢性阻塞性肺疾病合并呼吸衰竭療效觀察. 基層醫學論壇, 2018, 22(7): 904-905.
22. 顧小雷. 有創–無創機械通氣序貫治療慢性阻塞性肺疾病并呼吸衰竭臨床觀察. 中外醫學研究, 2019, 17(3): 30-31.
23. 沈艷, 沈雁波. 肺部感染控制窗和自主呼吸試驗在指導慢性阻塞性肺疾病急性發作機械通氣患者脫機時機的應用. 江蘇醫藥, 2015, 41(18): 2154-2156.
24. 符繼榮, 張志強, 劉大東. 不同切換點在慢性阻塞性肺疾病合并呼吸衰竭患者序貫通氣中的應用研究. 中華臨床醫師雜志(電子版), 2016, 10(11): 1648-1651.
25. Li PJ, Wang T, Xiao J. Efficacy of two noninvasive weaning strategies in intubated patients with chronic obstructive pulmonary disease: a meta-analysis and indirect treatment comparison. Heart Lung, 2016, 45(2): 132-139.
26. 張靜, 楊陽, 鄒俊. 肺部感染控制窗和自主呼吸試驗在無創正壓通氣序貫治療時機選擇中的運用. 護士進修雜志, 2015, 30(5): 446-448.

Chinese Journal of Respiratory and Critical Care Medicine

A meta-analysis on treatment effect of sequential noninvasive following invasive mechanical ventilation in chronic obstructive pulmonary disease patients with respiratory failure

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content