Effect of noninvasive respiratory support on interstitial lung disease with acute respiratory failure: A systematic review and meta-analysis

# Background Primary studies have demonstrated the effectiveness of noninvasive respiratory supports, including noninvasive positive pressure ventilation (NIPPV) and high flow nasal cannula (HFNC), for improving oxygenation and ventilation in patients with interstitial lung diseases (ILDs) and acut...

Full description

Saved in:
Bibliographic Details
Main Authors: Natthawan Sanguanwong, Nattawat Jantarangsi, Jinjuta Ngeyvijit, Natthida Owattanapanich, Vorakamol Phoophiboon
Format: Article
Language:English
Published: Canadian Society of Respiratory Therapists 2023-11-01
Series:Canadian Journal of Respiratory Therapy
Online Access:https://doi.org/10.29390/001c.89284
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1823857478302957568
author Natthawan Sanguanwong
Nattawat Jantarangsi
Jinjuta Ngeyvijit
Natthida Owattanapanich
Vorakamol Phoophiboon
author_facet Natthawan Sanguanwong
Nattawat Jantarangsi
Jinjuta Ngeyvijit
Natthida Owattanapanich
Vorakamol Phoophiboon
author_sort Natthawan Sanguanwong
collection DOAJ
description # Background Primary studies have demonstrated the effectiveness of noninvasive respiratory supports, including noninvasive positive pressure ventilation (NIPPV) and high flow nasal cannula (HFNC), for improving oxygenation and ventilation in patients with interstitial lung diseases (ILDs) and acute respiratory failure (ARF). These studies have not been synthesized and are not included in current practice guidelines. This systematic review with meta-analysis synthesizes studies that compared the effectiveness of NIPPV, HFNC and conventional oxygen therapy (COT) for improving oxygenation and ventilation in ILD patients with ARF. # Methods MEDLINE, EMBASE and the Cochrane Library searches were conducted from inception to August 2023. An additional search of relevant primary literature and review articles was also performed. A random effects model was used to estimate the PF ratio (ratio of arterial oxygen partial pressure to fractional inspired oxygen), PaCO~2~ (partial pressure of carbon dioxide), mortality, intubation rate and hospital length of stay. # Results Ten studies were included in the systematic review and meta-analysis. Noninvasive respiratory supports demonstrated a significant improvement in PF ratio compared to conventional oxygen therapy (COT); the mean difference was 55.92 (95% CI \[18.85-92.99\]; *p*=0.003). Compared to HFNC, there was a significant increase in PF ratio in NIPPV (mean difference 0.45; 95% CI \[0.12--0.79\]; *p*=0.008). There were no mortality and intubation rate benefits when comparing NIPPV and HFNC; the mean difference was 1.1; 95% CI \[0.83-1.44\]; *p*=0.51 and 1.86; 95% CI \[0.42-8.33\]; *p*=0.42, respectively. In addition, there was a significant decrease in hospital length of stay in HFNC compared to NIPPV (mean difference 9.27; 95% Cl \[1.45 -- 17.1\]; *p*=0.02). # Conclusions Noninvasive respiratory supports might be an alternative modality in ILDs with ARF. NIPPV demonstrated a potential to improve the PF ratio compared to HFNC. There was no evidence to support the benefit of NIPPV or HFNC in terms of mortality and intubation rate.
format Article
id doaj-art-273b0723e4144239a367ea6091c83ad8
institution Kabale University
issn 2368-6820
language English
publishDate 2023-11-01
publisher Canadian Society of Respiratory Therapists
record_format Article
series Canadian Journal of Respiratory Therapy
spelling doaj-art-273b0723e4144239a367ea6091c83ad82025-02-11T20:30:53ZengCanadian Society of Respiratory TherapistsCanadian Journal of Respiratory Therapy2368-68202023-11-0159Effect of noninvasive respiratory support on interstitial lung disease with acute respiratory failure: A systematic review and meta-analysisNatthawan SanguanwongNattawat JantarangsiJinjuta NgeyvijitNatthida OwattanapanichVorakamol Phoophiboon# Background Primary studies have demonstrated the effectiveness of noninvasive respiratory supports, including noninvasive positive pressure ventilation (NIPPV) and high flow nasal cannula (HFNC), for improving oxygenation and ventilation in patients with interstitial lung diseases (ILDs) and acute respiratory failure (ARF). These studies have not been synthesized and are not included in current practice guidelines. This systematic review with meta-analysis synthesizes studies that compared the effectiveness of NIPPV, HFNC and conventional oxygen therapy (COT) for improving oxygenation and ventilation in ILD patients with ARF. # Methods MEDLINE, EMBASE and the Cochrane Library searches were conducted from inception to August 2023. An additional search of relevant primary literature and review articles was also performed. A random effects model was used to estimate the PF ratio (ratio of arterial oxygen partial pressure to fractional inspired oxygen), PaCO~2~ (partial pressure of carbon dioxide), mortality, intubation rate and hospital length of stay. # Results Ten studies were included in the systematic review and meta-analysis. Noninvasive respiratory supports demonstrated a significant improvement in PF ratio compared to conventional oxygen therapy (COT); the mean difference was 55.92 (95% CI \[18.85-92.99\]; *p*=0.003). Compared to HFNC, there was a significant increase in PF ratio in NIPPV (mean difference 0.45; 95% CI \[0.12--0.79\]; *p*=0.008). There were no mortality and intubation rate benefits when comparing NIPPV and HFNC; the mean difference was 1.1; 95% CI \[0.83-1.44\]; *p*=0.51 and 1.86; 95% CI \[0.42-8.33\]; *p*=0.42, respectively. In addition, there was a significant decrease in hospital length of stay in HFNC compared to NIPPV (mean difference 9.27; 95% Cl \[1.45 -- 17.1\]; *p*=0.02). # Conclusions Noninvasive respiratory supports might be an alternative modality in ILDs with ARF. NIPPV demonstrated a potential to improve the PF ratio compared to HFNC. There was no evidence to support the benefit of NIPPV or HFNC in terms of mortality and intubation rate.https://doi.org/10.29390/001c.89284
spellingShingle Natthawan Sanguanwong
Nattawat Jantarangsi
Jinjuta Ngeyvijit
Natthida Owattanapanich
Vorakamol Phoophiboon
Effect of noninvasive respiratory support on interstitial lung disease with acute respiratory failure: A systematic review and meta-analysis
Canadian Journal of Respiratory Therapy
title Effect of noninvasive respiratory support on interstitial lung disease with acute respiratory failure: A systematic review and meta-analysis
title_full Effect of noninvasive respiratory support on interstitial lung disease with acute respiratory failure: A systematic review and meta-analysis
title_fullStr Effect of noninvasive respiratory support on interstitial lung disease with acute respiratory failure: A systematic review and meta-analysis
title_full_unstemmed Effect of noninvasive respiratory support on interstitial lung disease with acute respiratory failure: A systematic review and meta-analysis
title_short Effect of noninvasive respiratory support on interstitial lung disease with acute respiratory failure: A systematic review and meta-analysis
title_sort effect of noninvasive respiratory support on interstitial lung disease with acute respiratory failure a systematic review and meta analysis
url https://doi.org/10.29390/001c.89284
work_keys_str_mv AT natthawansanguanwong effectofnoninvasiverespiratorysupportoninterstitiallungdiseasewithacuterespiratoryfailureasystematicreviewandmetaanalysis
AT nattawatjantarangsi effectofnoninvasiverespiratorysupportoninterstitiallungdiseasewithacuterespiratoryfailureasystematicreviewandmetaanalysis
AT jinjutangeyvijit effectofnoninvasiverespiratorysupportoninterstitiallungdiseasewithacuterespiratoryfailureasystematicreviewandmetaanalysis
AT natthidaowattanapanich effectofnoninvasiverespiratorysupportoninterstitiallungdiseasewithacuterespiratoryfailureasystematicreviewandmetaanalysis
AT vorakamolphoophiboon effectofnoninvasiverespiratorysupportoninterstitiallungdiseasewithacuterespiratoryfailureasystematicreviewandmetaanalysis