Incidence of noninvasive ventilation failure and mortality in patients with acute respiratory distress syndrome: a systematic review and proportion meta-analysis

作者全名："Wang, Jie; Duan, Jun; Zhou, Ling"

作者地址："[Wang, Jie] Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, Youyi Rd 1, Chongqing 400016, Peoples R China; [Duan, Jun] Chongqing Med Univ, Affiliated Hosp 1, Dept Resp & Crit Care Med, Youyi Rd 1, Chongqing 400016, Peoples R China; [Zhou, Ling] Song Shan Hosp Chongqing, Dept Med Lab, 69 Renhe Xingguang Ave, Chongqing 401121, Peoples R China"

通信作者："Duan, J (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Resp & Crit Care Med, Youyi Rd 1, Chongqing 400016, Peoples R China.; Zhou, L (通讯作者)，Song Shan Hosp Chongqing, Dept Med Lab, 69 Renhe Xingguang Ave, Chongqing 401121, Peoples R China."

来源：BMC PULMONARY MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001157235100002

JCR分区：Q2

影响因子：3.1

年份：2024

卷号：24

期号：1

开始页：　

结束页：　

文献类型：Review

关键词：Noninvasive ventilation; ARDS; Treatment failure; Mortality

摘要："Background Noninvasive ventilation (NIV) is commonly used in patients with acute respiratory distress syndrome (ARDS). However, the incidence and distribution of treatment failure are unclear. Methods A comprehensive online search was conducted to select potentially eligible studies with reports of the rate of NIV failure in patients with ARDS. A manual search was also performed to identify additional studies. Data were extracted to calculate the pooled incidences of NIV failure and mortality. Based on oxygenation, the severity of the disease was classified as mild, moderate, or severe ARDS. Based on etiologies, ARDS was defined as being of pulmonary origin or extrapulmonary origin. Results We enrolled 90 studies in this meta-analysis, involving 98 study arms. The pooled incidence of NIV failure was 48% (n = 5847, 95% confidence interval [CI]: 43-52%). The pooled incidence of ICU mortality was 29% (n = 2363, 95%CI: 22-36%), and that of hospital mortality was 33% (n = 2927, 95%CI: 27-40%). In patients with mild, moderate, and severe ARDS, the pooled incidence of NIV failure was 30% (n = 819, 95%CI: 21-39%), 51% (n = 1332, 95%CI: 43-60%), and 71% (n = 525, 95%CI: 62-79%), respectively. In patients with pulmonary ARDS, it was 45% (n = 2687, 95%CI: 39-51%). However, it was 30% (n = 802, 95%CI: 21-38%) in those with extrapulmonary ARDS. In patients with immunosuppression, the incidence of NIV failure was 62% (n = 806, 95%CI: 50-74%). However, it was 46% (n = 5041, 95%CI: 41-50%) in those without immunosuppression. Conclusions Nearly half of patients with ARDS experience NIV failure. The incidence of NIV failure increases with increasing ARDS severity. Pulmonary ARDS seems to have a higher rate of NIV failure than extrapulmonary ARDS. ARDS patients with immunosuppression have the highest rate of NIV failure."

基金机构：Chongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau)

基金资助正文：No Statement Available