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Meta-Analysis
. 2023 Feb 1;24(2):123-132.
doi: 10.1097/PCC.0000000000003109. Epub 2022 Dec 13.

Noninvasive Ventilation for Acute Respiratory Failure in Pediatric Patients: A Systematic Review and Meta-Analysis

Daniele Boghi  1 , Kyung Woo Kim  2 , Jun Hyun Kim  2 , Sang-Il Lee  2 , Ji Yeon Kim  2 , Kyung-Tae Kim  2 , Andrea Ambrosoli  1 , Giovanni Guarneri  3 , Giovanni Landoni  3   4 , Luca Cabrini  5   6
Affiliations
Meta-Analysis

Noninvasive Ventilation for Acute Respiratory Failure in Pediatric Patients: A Systematic Review and Meta-Analysis

Daniele Boghi et al. Pediatr Crit Care Med. .

Abstract

Objective: To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) on the use of noninvasive ventilation (NIV) for acute respiratory failure (ARF) in pediatric patients.

Data sources: We searched PubMed, EMBASE, the Cochrane Central Register of Clinical Trials, and Clinicaltrials.gov with a last update on July 31, 2022.

Study selection: We included RCTs comparing NIV with any comparator (standard oxygen therapy and high-flow nasal cannula [HFNC]) in pediatric patients with ARF. We excluded studies performed on neonates and on chronic respiratory failure patients.

Data extraction: Baseline characteristics, intubation rate, mortality, and hospital and ICU length of stays were extracted by trained investigators.

Data synthesis: We identified 15 RCTs (2,679 patients) for the final analyses. The intubation rate was 109 of 945 (11.5%) in the NIV group, and 158 of 1,086 (14.5%) in the control group (risk ratio, 0.791; 95% CI, 0.629-0.996; p = 0.046; I2 = 0%; number needed to treat = 31). Findings were strengthened after removing studies with intervention duration shorter than an hour and after excluding studies with cross-over as rescue treatment. There was no difference in mortality, and ICU and hospital length of stays.

Conclusions: In pediatric patients, NIV applied for ARF might reduce the intubation rate compared with standard oxygen therapy or HFNC. No difference in mortality was observed.

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Conflict of interest statement

The authors have disclosed that they do not have any potential conflicts of interest.

References

    1. Nava S, Hill N: Non-invasive ventilation in acute respiratory failure. Lancet 2009; 374:250–259
    1. Rochwerg B, Brochard L, Elliott MW, et al.: Official ERS/ATS clinical practice guidelines: Noninvasive ventilation for acute respiratory failure. Eur Respir J 2017; 50:1602426
    1. Cabrini L, Landoni G, Oriani A, et al.: Noninvasive ventilation and survival in acute care settings: A comprehensive systematic review and metaanalysis of randomized controlled trials. Crit Care Med 2015; 43:880–888
    1. Cabrini L, Landoni G, Bocchino S, et al.: Long-term survival rate in patients with acute respiratory failure treated with noninvasive ventilation in ordinary wards. Crit Care Med 2016; 44:2139–2144
    1. Najaf-Zadeh A, Leclerc F: Noninvasive positive pressure ventilation for acute respiratory failure in children: A concise review. Ann Intensive Care 2011; 1:15