Chest
ReviewsA Meta-analysis of Nocturnal Noninvasive Positive Pressure Ventilation in Patients With Stable COPD
Section snippets
Search Strategy
RCTs were identified from several sources. Through the Cochrane Airways group registry, we searched for RCTs in MEDLINE, EMBASE, and CINAHL in all languages. The following terms were used to identify trials related to NIPPV: nasal ventilation or positive pressure or NIPPV. The bibliographies of all relevant articles were hand searched for additional articles that may contain RCTs. In addition, records were identified through hand searching of abstracts from meetings of the American Thoracic
Results
The publications were reduced to 10 potentially eligible articles from 164 publications retrieved from computer searches and 8 further abstracts identified. Four trials were excluded for the following reasons: the study was not randomized23 and the duration of bilevel pressure ventilation was too short (< 5 h per night),2425 and the training period of bilevel pressure ventilation was too short (< 3 weeks).26 Two publications (abstracts) pertained to long-term European multicenter studies of
Discussion
This meta-analysis showed that nocturnal NIPPV for 3 months in hypercapnic patients with COPD did not have clinically or statistically significant effects on lung function, gas exchange, or sleep efficiency. The small sample size precludes a definitive statement regarding the clinical implications of NIPPV, other than stating that at present there is insufficient evidence from short-term trials to support its widespread use. The small positive treatment effects for Pimax and Pemax are unlikely
ACKNOWLEDGMENT
We thank Carol C. Carlisle (Rhode Island Hospital, Providence, RI) for helping us with the data from their study,14 which was included in this meta-analysis.
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