title: Efficacy of noninvasive ventilation after planned extubation: A systematic review and meta-analysis of randomized controlled trials.
abstract: The objective our meta-analysis is to update the evidence on the efficacy of noninvasive ventilation (NIV) compared with conventional oxygen therapy after planned extubation. We did a systematic literature review of database, including Pubmed, EMBASE, and Cochrane. We included randomized controlled trials comparing NIV with conventional oxygen therapy after planned extubation in medical intensive care unit (ICU) in our analysis. The results of our meta-analysis is consistent with the results of previous reviews and show that NIV decreased reintubation rate significantly as compared to conventional oxygen therapy in chronic obstructive pulmonary disease (COPD) and patients at high risk for extubation failure; COPD (RR, 0.33; 95% CI, 0.16-0.69; I2 = 0), high risk (RR, 0.47; 95% CI, 0.32-0.70; I2 = 0). However, in a mixed medical ICU population, there was no statistical difference of reintubation rate between the two groups (RR, 0.66; 95% CI, 0.25-1.73; I2 = 68%). Our study suggests that use of NIV after planned extubation significantly decreases the reintubation rate in COPD patients and patients at high risk for extubation failure, confirming the findings of previous reviews. There is no difference in the reintubation rate between the two groups in the mixed medical ICU population.
authors.affiliation: The Wright Center for Graduate Medical Education, 501 Madison Avenue, Scranton, PA, USA. Electronic address: dr.anuragbajaj@gmail.com.
authors.forename: Anurag
authors.initials: A
authors.lastname: Bajaj
authors.affiliation: Zhengzhou University, 100 Ke Xue Da Dao, Zhongyuan, Zhengzhou, Henan, China.
authors.forename: Parul
authors.initials: P
authors.lastname: Rathor
authors.affiliation: The Common Wealth Medical College, 525 Pine Street, Scranton, PA, USA.
authors.forename: Vishal
authors.initials: V
authors.lastname: Sehgal
authors.affiliation: Pulmonary and Critical Care Division, The Common Wealth Medical College, 525 Pine street, Scranton, PA, USA.
authors.forename: Ajay
authors.initials: A
authors.lastname: Shetty
mesh_terms: D060666:Airway Extubation; D006801:Humans; D007442:Intubation, Intratracheal; D063087:Noninvasive Ventilation / Q000379:methods*; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D016032:Randomized Controlled Trials as Topic
keywords: Chronic obstructive pulmonary disease; Extubation; Mechanical ventilation; Noninvasive ventilation; Randomized controlled trial; Reintubation