Background:
The study aimed to evaluate the efficacy and safety of invasivenoninvasive
sequential ventilation versus invasive ventilation in the treatment of Acute
Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD).
Method:
PubMed, Cochrane, Embase, Wanfang, CNKI, VIP database were searched by the index
words to identify the qualified RCTs, and relevant literature sources were also searched. The latest
research was conducted in June 2017. Relative Risks (RR), and Mean Difference (MD) along with
95% confidence interval (95% CI) were used to analyze the main outcomes.
Result:
Twenty-nine RCTs were involved in this analysis of 1061 patients in the invasivenoninvasive
sequential ventilation group (In-non group) and 1074 patients in the invasive
ventilation group (In group). The results indicated that compared with the invasive ventilation,
invasive-noninvasive sequential ventilation would significantly decrease the incidence of VAP
(RR:0.20, 95%CI: 0.16-0.26), mortality (RR:0.38, 95%CI: 0.26-0.55), reintubation (RR:0.39,
95%CI: 0.27-0.55); and statistically reduced the duration of invasive ventilation (MD:-9.23,
95%CI: -10.65, -7.82), the total duration of mechanical ventilation (MD:-4.91, 95%CI: -5.99,
-3.83), and the length of stay in the ICU (MD:-5.10, 95%CI: -5.43, -4.76).
Conclusion:
The results demonstrated that the application of noninvasive sequential ventilation
after invasive ventilation at the pulmonary infection control window has a significant influence on
VAP incidence, mortality, and the length of stay in the ICU, but further well-designed, adequately
powered RCTs are required to validate the conclusion.
A Prediction Model for Intermediate- and High-risk Pulmonary Hypertension During the Acute Exacerbation of Chronic Obstructive Pulmonary Disease
