Table 1.
Summary of basic characteristics of studies selected for inclusion in meta-analysis
| Study | Study design | Disease | Causes | Patients, n | Interventions | Content of therapy | Mean age, years | Male | Severity of illness | PaO 2/FiO 2, mmHg | Comorbidity |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Zhu32 | RCT | ARF | ACPE, ALI, lobar atelectasis, pneumonia, COPD, RMF | 48 | NPPV | Bilevel positive airways pressure S/T mode (BiPAP) via a face mask via a face mask | 62 | 67% | 17.2* | NA | HT, DM |
| 47 | Control | Standard medical care and oxygen therapy as needed | 61 | 57% | 17.6* | ||||||
| Zhan24 | RCT | ALI | Pulmonary infection, acute pancreatitis, multiple trauma, sepsis | 21 | NPPV | Bilevel positive airways pressure S/T mode (BiPAP) via a face mask | 44 | 76% | 11.8* | 225.4 (17.4) | HT, immunosuppres-sion, DM, chronic renal insufficiency, cancer |
| 19 | Control | High-concentration oxygen therapy through a Venturi mask | 49 | 42% | 13.4* | 234.4 (26.6) | |||||
| Uçgun25 | Prospective | ARDS | NA | 10 | NPPV | A BiPAP vision ventilator device was used in BIPAP mode via a CPAP full-face mask | 43 | 90% | 17.4* | 110 | NA |
| 10 | Control | Standard therapy (such as oxygen, antibiotics, and bronchodilators) | 47 | 80% | 18.8* | 103.3 | |||||
| De Santo26 | Prospective | ARF | Post-cardiopulmonary bypass lung injury, cardiogenic oedema, pneumonia | 43 | NPPV | Helmet | 66 | 74% | NA | 357 (60.4) | DM, COPD, low LVEF |
| 422 | Control | NA | 62 | 69% | NA | 381 (41) | |||||
| Yañez31 | RCT | ARF | NA | 25 | NIV | Positive airways pressure STD 30 mode (BiPAP) via a face mask | 16 | 68% | NA | Median (IQR): 150 (110-383) | Moderate asthma, viral pneumonia and/or bronchiolitis, bacterial pneumonia, RSV pneumonia, bronchiolitis, parainfluenza, pneumonia |
| 25 | Control | Standard treatment (mask oxygen) | 18 | 52% | NA | Median (IQR): 190 (101-400) | |||||
| Thys28 | RCT | ARF | Acute pulmonary oedema, acute exacerbation of COPD | 10 | NPPV | Bilevel positive airways pressure S/TD 30 mode (BiPAP) via a face mask via a face mask | 71 | 70% | NA | NA | NA |
| 10 | Control | Oxygen therapy + Placebo-device | 76 | 40% | |||||||
| Auriant34 | RCT | ARF | Interstitial pulmonary oedema, atelectasis, documented pneumonia | 24 | NPPV | Bilevel positive airways pressure S/TD 30 mode (BiPAP) via an nasal mask | 59 | NA | 16.9^ | 126.8 (42.1) | NA |
| 24 | Control | Standard therapy (oxygen, bronchodilatators, patient controlled analgesia, chest physiotherapy) | 63 | NA | 16.8^ | 127.1 (42.5) | |||||
| Antonelli16 | RCT | ARF | Pneumonia, ACPE, ARDS, mucous plugging or atelectasis, pulmonary embolism | 20 | NPPV | Bilevel positive airway pressure via a full face mask | 45 | 65% | 13^ | 129 (30) | NA |
| 20 | Control | Oxygen supplementation | 44 | 60% | 13^ | 129 (30) | |||||
| Martin33 | RCT | ARF | Hypercapnic, hypoxemic | 32 | NPPV | Bilevel positive airways pressure S/TD mode (BiPAP) via an nasal mask | 64 | 47% | 58# | Hypercapnic ARF: 190(68) Hypoxemic ARF:103 (35) | COPD, Non-COPD-related pulmonary disease |
| 29 | Control | Usual medical care | 58 | 48% | 65# | Hypercapnic ARF: 208 (90) Hypoxemic ARF:110 (43) | |||||
| Confalonieri27 | RCT | ARF | Severe community-acquired pneumonia | 28 | NPPV | Continuous positive airway pressure through full-face mask | 66 | 82% | 20* | 183 (36) | COPD |
| 28 | Control | Standard treatment with oxygen supplementation delivered by a Venturi mask | 61 | 61% | 18* | 167 (47) | |||||
| Wood29 | RCT | ARDS | ACPE, COPD, pneumonia, interstitial lung disease, sepsis | 16 | NPPV | Hospital-grade ventilatory support systems (BiPAP) stationed in the ED. via an nasal mask | 56 | 69% | 18.1* | NA | NA |
| 11 | Control | Conventional medical therapy (supplemental oxygen and pharmacologic therapy) | 62 | 46% | 15.6* | ||||||
| Wysocki30 | RCT | ARF | Pneumonia, ACPE, Laryngeal dyspnea, chest wall impairment | 21 | NIPSV | NIPSV was delivered to the patient through a full-face mask | 64 | 57% | 17^ | NA | NA |
| 20 | Control | Medications related to the cause of respiratory distress (antibiotics, diuretics, inotropics, etc) and oxygen supplementation | 62 | 60% | 12^ |
*APACHE (Acute Physiology and Chronic Health Evaluation) II score
^SAPS II (Simplified Acute Physiology Score)
#APACHE III score
ACPE = acute cardiogenic pulmonary oedema; ALI = acute lung injury; ARDS = acute respiratory distress syndrome; ARF = acute respiratory failure; COPD = chronic obstructive pulmonary disease; DM = diabetes mellitus; HT = hypertension; LVEF = left ventricular ejection fraction; NA = not available; NIV = non-invasive ventilation; NIPSV = non-invasive pressure support ventilation; NPPV = non-invasive positive-pressure ventilation; RCT = randomised controlled trial; RMF = respiratory muscle fatigue; RSV = respiratory syncytial virus