Helmet CPAP versus Oxygen Therapy in Hypoxemic Acute Respiratory Failure: A Meta-Analysis of Randomized Controlled Trials
Yonsei Medical Journal
;
: 936-941, 2016.
Article
Dans Anglais
| WPRIM
| ID: wpr-63329
ABSTRACT
PURPOSE:
The efficacy of helmet continuous positive airway pressure (CPAP) in hypoxemic acute respiratory failure (hARF) remains unclear. The aim of this meta-analysis was to critically review studies that investigated the effect of helmet CPAP on gas exchange, mortality, and intubation rate in comparison with standard oxygen therapy. MATERIALS ANDMETHODS:
We performed a meta-analysis of randomized controlled trials (RCTs) by searching the PubMed, Embase, Cochrane library, OVID, and CBM databases, and the bibliographies of the retrieved articles. Studies that enrolled adults with hARF who were treated with helmet CPAP and measured at least one of the following parameters were included gas exchange, intubation rate, in-hospital mortality rate.RESULTS:
Four studies with 377 subjects met the inclusion criteria and were analyzed. Compared to the standard oxygen therapy, helmet CPAP significantly increased the PaO2/FiO2 [weighted mean difference (WMD)=73.40, 95% confidence interval (95% CI) 43.92 to 102.87, p<0.00001], and decreased the arterial carbon dioxide levels (WMD=-1.92, 95% CI -3.21 to -0.63, p=0.003), intubation rate [relative risk (RR)=0.21, 95% CI 0.11 to 0.40, p<0.00001], and in-hospital mortality rate (RR=0.22, 95% CI 0.09 to 0.50, p=0.0004).CONCLUSION:
The results of this meta-analysis suggest that helmet CPAP improves oxygenation and reduces mortality and intubation rates in hARF. However, the significant clinical and statistical heterogeneity of the literature implies that large RCTs are needed to determine the role of helmet CPAP in different hypoxemic ARF populations.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Oxygénothérapie
/
Insuffisance respiratoire
/
Essais contrôlés randomisés comme sujet
/
Maladie aigüe
/
Mortalité hospitalière
/
Ventilation en pression positive continue
Type d'étude:
Essai clinique contrôlé
/
Etude d'étiologie
/
Revues systématiques évaluées
Limites du sujet:
Adulte
/
Humains
langue:
Anglais
Texte intégral:
Yonsei Medical Journal
Année:
2016
Type:
Article
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