Respiratory failure & ventilation
Noninvasive Oxygenation Strategies in Adult Patients With Acute Hypoxemic Respiratory Failure: A Systematic Review and Network Meta-Analysis
Pooled result · MortalityResult — go to the resultAbsolute risk difference per 1,000 231 fewer deaths 95% CI 126-273 fewerAuthors' conclusion
A helmet interface for noninvasive ventilation probably reduces mortality and the risk of mechanical ventilation, as well as the duration of hospital and ICU stay. An HFNC probably reduces the risk of invasive mechanical ventilation and may be as comfortable as SOT.
Study context
- Population
- Adults with acute hypoxemic respiratory failure
- Participants
- 7,046 adults · 36 trials
- Comparison
- Noninvasive oxygenation strategies vs standard oxygen therapy (SOT)
- Outcome
- Mortality
Methodological detailsrandom effects, frequentist, GRADE certainty of evidence
- Random effects
- Frequentist
- GRADE certainty of evidence
Pooled result
As reported in the abstract
Absolute risk difference per 1,000
231 fewer deaths
95% CI 126-273 fewer
Further pooled results
| Outcome | Estimate |
|---|---|
| Invasive mechanical ventilationHFNC vs SOT · moderate certainty | absolute risk difference per 1,000 103.5 fewer events (95% CI 40.5-157.5 fewer) |
| ICU LOSHelmet bilevel ventilation vs SOT · low certainty | difference 4.84 fewer days (95% CI 2.33-7.36 days fewer) |
| ICU LOSHelmet CPAP vs SOT · low certainty | difference 1.74 fewer days (95% CI 4.49 fewer-1.01 more) |
Duration of hospitalization
- All noninvasive oxygenation strategies may reduce duration of hospitalization vs SOT (low certainty)
Comfort
- SOT may be more comfortable than face mask NIV and no different vs high-flow nasal cannula (HFNC) (both low certainty)
Original publication
Noninvasive Oxygenation Strategies in Adult Patients With Acute Hypoxemic Respiratory Failure: A Systematic Review and Network Meta-Analysis. Chest. Published 20 April 2023. doi:10.
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