Efficacy of non-invasive and invasive respiratory management strategies in adult patients with acute hypoxaemic respiratory failure: a systematic review and network meta-analysis

Sakuraya, Masaaki; Okano, Hiromu; Masuyama, Tomoyuki; Kimata, Shunsuke; Hokari, Satoshi

doi:10.1186/s13054-021-03835-8

Critical Care

Table 1 Summary of the characteristics of the studies included in the network meta-analysis

From: Efficacy of non-invasive and invasive respiratory management strategies in adult patients with acute hypoxaemic respiratory failure: a systematic review and network meta-analysis

Source	Funding	Total No. of patients	Main cause for respiratory failure	No. of immunocompromised patients, n (%)	Age, year	P/F ratio	RR, /min	PaCO₂, mmHg	Main exposure	Interface, NIV mode	Comparator	Outcomes of interest assessed	Timing of measurement for mortality
Wysock [31]	Undisclosed	41	Mixed ARF (CAP 39.0%, CPO 34.1%)	NA	63	207	35	43	Non-invasive ventilation (N = 21)	Face mask, pressure support	Standard oxygen (N = 20)	Mortality, intubation	ICU discharge
Antolnelli [49]	Undisclosed	64	Mixed ARF (ARDS 25.0%, atelectasis 25.0%, CPO 18.8%)	0 (0)	54	120	39	40	Non-invasive ventilation ( N = 32)	Face mask, pressure support	Invasive ventilation, tidal volume 10 ml/kg (N = 32)	Mortality	Hospital discharge
Confalonieri [32]	Undisclosed	56	CAP	NA	64	175	37	49	Non-invasive ventilation ( N = 28)	Face mask, pressure support	Standard oxygen (N = 28)	Mortality, intubation	2-month
Antonelli [33]	Undisclosed	40	Mixed ARF (ARDS 37.5%, atelectasis 25.0%, CPO 22.5%)	40 (100)	67	NA	NA	40	Non-invasive ventilation (N = 20)	Face mask, pressure support	Standard oxygen (N = 20)	Mortality, intubation	Hospital discharge
Delcaux [40]	Vital Signs Inc	123	Mixed ARF (CAP 42.3%)^a	NA	58^b	144^a	33	36^b	Non-invasive ventilation (N = 62)	FACE mask, CPAP	Standard oxygen (N = 61)	Mortality, intubation	Hospital discharge
Martin [41]	Undisclosed	61	Mixed ARF (non-COPD disease 62.3%)	NA	61	199	28	57	Non-invasive ventilation (N = 32)	Nasal mask, CPAP	Standard oxygen (N = 29)	Mortality, intubation	ICU discharge
Hilbert [34]	Undisclosed	52	CAP	52 (100)	49	139	36	38	Non-invasive ventilation (N = 26)	Face mask, pressure support	Standard oxygen (N = 26)	Mortality, intubation	Hospital discharge
Ferrer [35]	Red GIRA, Red Respira, and Carburos Metalicos SA	105	Mixed ARF (CAP 32.4%, CPO 28.6%, ARDS 14.3%)	19 (18.1)	62	103	37	37	Non-invasive ventilation (N = 51)	Face mask, pressure support	Standard oxygen (N = 54)	Mortality, intubation	ICU discharge
Cosentini [42]	Undisclosed	47	CAP^c	0 (0)	69	248	27	35	Non-invasive ventilation (N = 20)	Helmet, CPAP	Standard oxygen (N = 27)	Mortality, intubation	Hospital discharge
Squadrone [43]	Regione Piemonte (CEP AN RAN 07) and Ministero dell’Università (PRIN RANI 07)	40	Mixed ARF^c	40 (100)	49	269	30	36	Non-invasive ventilation (N = 20)	Helmet, CPAP	Standard oxygen (N = 20)	Mortality, intubation	Hospital discharge
Wermke [36]	Undisclosed	86	CAP^c	86 (100)	52^b	270	NA	NA	Non-invasive ventilation (N = 42)	Face mask, pressure support	Standard oxygen (N = 44)	Mortality, intubation	100 days
Zhan [37]	Beijing Municipal Science and Technology Commission Program	40	ALI	11 (27.5)	46	230	20	32	Non-invasive ventilation (N = 21)	Face mask, pressure support	Standard oxygen (N = 19)	Mortality, intubation	Hospital discharge
Brambilila [44]	RCCS Fondazione Ca’Granda, Ospedale Maggiore Policlinico, Milan	81	CAP^c	26 (32.1)	67	141	34	33	Non-invasive ventilation (N = 40)	Helmet, CPAP	Standard oxygen (N = 41)	Mortality, intubation	Hospital discharge
Azevedo [52]	Undisclosed	30	Mixed ARF (CPO 43.3%, CAP 33.3%)	NA	67	NA	NA	NA	Non-invasive ventilation (N = 16)	Face mask, pressure support	High-flow nasal oxygen (N = 14)	Intubation	ICU discharge
Frat [7]	French Ministry of Health	310	Mixed ARF (CAP 63.5%)^c	82 (26.5)	60	155	33	35	Non-invasive ventilation (N = 110)	Face mask, pressure suppose	High-flow nasal oxygen (N = 106); standard oxygen (N = 94)	Mortality, intubation	90 days
Lamiale [45]	Fisher & Paykel	100	Mixed ARF (sepsis related 50%, CPO 7.0%)	100 (100)	62	114	27	NA	High-flow nasal oxygen (N = 52)	–	Standard oxygen (N = 48)	Intubation	ICU discharge
Lemiale [38]	Legs Poix (Chancellerie des Universités de Paris) and OUTCOMEREA Study Group	374	Mixed ARF (Pneumonia 68.7%)^c	374 (100)	63^b	142	26	NA	Non-invasive ventilation (N = 191)	Face mask, pressure support	Standard oxygen (N = 183)	Mortality, intubation	28 days
Jones [46]	Greenlane Research and Education Fund	303	Mixed ARF (COPD 23.9%, Pneumonia 23.8%, CPO 14.2%)	NA	73	NA	33	NA	High-flow nasal oxygen (N = 165)	–	Standard oxygen (N = 138)	Mortality, intubation	90 days
Muncharaz [50]	Undisclosed	65	Mixed ARF (CAP 63.1%, ARDS 18.5%)^c	0 (0)	62^b	97	36	44	Non-invasive ventilation (N = 34)	Face mask, pressure support	Invasive ventilation, tidal volume 8–10 ml/kg (PBW), Ppl < 35 (N = 31)	Mortality	Hospital discharge
Azoulay [8]	French Ministry of Health	776	Mixed ARF (Pneumonia 53.0%)^c	776 (100)	64	132	33	NA	High-flow nasal oxygen (N = 388)	–	Standard oxygen (N = 388)	Mortality, intubation	90 days
He [39]	National Natural Science Foundation of China	200	ARDS due to CAP	19 (9.5)	55	231	25	34	Non-invasive ventilation (N = 102)	Face mask, pressure support	Standard oxygen (N = 98)	Mortality, intubation	Hospital discharge
Andino [47]	Spanish Ministry of Health, Social Services, and Equality	46	Mixed ARF (CAP 30%, HAP 26%)^c	NA	60	96	32	34.3	High-flow nasal oxygen (N = 24)		Standard oxygen (N = 22)	Mortality, intubation	Hospital discharge
Awadallah [51]	None	52	ARDS	NA	52	94.5	NA	33	Non-invasive ventilation (N = 26)	Face mask, pressure support	Invasive ventilation, tidal volume 6–7 ml/kg (PBW), Ppl < 30 (N = 26)	Mortality	Hospital discharge
Grieco [53]	2017 Merck Sharp & Dohme SRL award	109	ARF in COVID-19 patients^c	8 (7.3)	65^b	102^b	28^b	34^b	Non-invasive ventilation (N = 54)	Helmet, pressure support	High-flow nasal oxygen (N = 55)	Mortality, intubation	60 days
AlptekİnoĞlu Mendİl [48]	None	100	Mixed ARF (pneumonia 74%)^c	100 (100)	59^b	262^b	NA	30^b	High-flow nasal oxygen (N = 51)		Standard oxygen (N = 49)	Mortality, intubation	28 days

ALI, acute lung injury; ARDS, acute respiratory distress syndrome; ARF, acute respiratory failure; CAP, community-acquired pneumonia; CPAP, continuous positive airway pressure; COPD, chronic obstructive pulmonary disease; COVID-19, coronavirus disease 2019; CPO, cardiopulmonary oedema; HAP, hospital-acquired pneumonia; ICU, intensive care unit; NA, not available; NIV, non-invasive ventilation; P/F ratio, ratio of arterial oxygen partial pressure to fractional inspired oxygen; PaCO₂, partial pressure of arterial carbon dioxide; Ppl, plateau pressure; PBW, predicted body weight; RR, respiratory rate
^aForty-two patients had a cardiac disease
^bThe measurement value was reported as median
^cExcluded patients with CPO

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