title: Oxygen therapy for pneumonia in adults.
abstract: BACKGROUND
  Oxygen therapy is widely used in the treatment of lung diseases. However, the effectiveness of oxygen therapy as a treatment for pneumonia is not well known.
  
  
  OBJECTIVE
  To determine the effectiveness and safety of oxygen therapy in the treatment of pneumonia in adults older than 18 years.
  
  
  METHODS
  We searched the Cochrane Central Register of Controlled Trials (CENTRAL) 2011, Issue 4, part of The Cochrane Library, www.thecochranelibrary.com (accessed 9 December 2011), which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1948 to November week 3, 2011) and EMBASE (1974 to December 2011).
  
  
  METHODS
  Randomised controlled trials (RCTs) of oxygen therapy for adults with community-acquired pneumonia (CAP) and nosocomial (hospital-acquired) pneumonia (HAP or NP) in intensive care units (ICU).
  
  
  METHODS
  Two review authors independently reviewed abstracts and assessed data for methodological quality.
  
  
  RESULTS
  Three RCTs met our inclusion criteria. The studies enrolled 151 participants with CAP or immunosuppressed patients with pulmonary infiltrates. Overall, we found that non-invasive ventilation can reduce the risk of death in the ICU, odd ratio (OR) 0.28, 95% confidence interval (CI) 0.09 to 0.88; endotracheal intubation, OR 0.26, 95% CI 0.11 to 0.61; complications, OR 0.23, 95% CI 0.08 to 0.70; and shorten ICU length of stay, mean duration (MD) -3.28, 95% CI -5.41 to -1.61.Non-invasive ventilation and standard oxygen supplementation via a Venturi mask were similar when measuring mortality in hospital, OR 0.54, 95% CI 0.11 to 2.68; two-month survival, OR 1.67, 95% CI 0.53 to 5.28; duration of hospital stay, MD -1.00, 95% CI -2.05 to 0.05; and duration of mechanical ventilation, standard MD -0.26, 95% CI -0.66 to 0.14. Some outcomes and complications of non-invasive ventilation were varied according to different participant populations. We also found that some subgroups had a high level of heterogeneity when conducting pooled analyses.
  
  
  CONCLUSIONS
  Non-invasive ventilation can reduce the risk of death in the ICU, endotracheal intubation, shorten ICU stay and length of intubation. Some outcomes and complications of non-invasive ventilation were varied according to different participant populations. Other than the oxygen therapy, we must mention the importance of standard treatment by physicians. The evidence is weak and we did not include participants with pulmonary tuberculosis and cystic fibrosis. More RCTs are required to answer these clinical questions. However, the review indicates that non-invasive ventilation may be more beneficial than standard oxygen supplementation via a Venturi mask for pneumonia.
authors.affiliation: Department of Gerontology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Yanling
authors.initials: Y
authors.lastname: Zhang
authors.forename: Chenli
authors.initials: C
authors.lastname: Fang
authors.forename: Bi Rong
authors.initials: BR
authors.lastname: Dong
authors.forename: Taixiang
authors.initials: T
authors.lastname: Wu
authors.forename: Jue Lin
authors.initials: JL
authors.lastname: Deng
mesh_terms: D000328:Adult; D017714:Community-Acquired Infections / Q000628:therapy; D006801:Humans; D010102:Oxygen Inhalation Therapy; D011014:Pneumonia / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D012121:Respiration, Artificial / Q000379:methods