The roles of noninvasive mechanical ventilation with helmet in patients with acute respiratory failure: A systematic review and meta-analysis
To compare the safety and effectiveness between helmet and face mask noninvasive mechanical ventilation (NIMV) in patients with acute respiratory failure (ARF). English databases included PubMed, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science. Chinese databases involved Wa...
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| creator | Hong, Shukun Wang, Hongye Tian, Yonggang Qiao, Lujun |
| description | To compare the safety and effectiveness between helmet and face mask noninvasive mechanical ventilation (NIMV) in patients with acute respiratory failure (ARF).
English databases included PubMed, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science. Chinese databases involved Wanfang Data, China Knowledge Resource Integrated Database and Chinese Biological Medicine Database. Randomized controlled trials (RCTs) comparing helmet and face mask NIMV for patients with ARF were searched. Meta-analysis was performed using Review manager 5.1.0.
Twelve trials with a total of 569 patients were eligible. Our meta-analysis showed that, comparing with face mask, helmet could significantly decrease the incidences of intolerance [risk ratio (RR) 0.19; 95% confidence interval (CI) 0.09-0.39], facial skin ulcer (RR 0.19; 95% CI 0.08-0.43) and aerophagia (RR 0.15; 95% CI 0.06-0.37), reduce respiratory rate [mean difference (MD) -3.10; 95% CI -4.85 to -1.34], intubation rate (RR 0.39; 95% CI 0.26-0.59) and hospital mortality (RR 0.62; 95% CI 0.39-0.99) in patients with ARF, and improve oxygenation index in patients with hypoxemic ARF (MD 55.23; 95% CI 31.37-79.09). However, subgroupanalysis for hypercapnic ARF revealed that PaCO2 was significantly reduced in face mask group compared with helmet group (MD 5.34; 95% CI 3.41-7.27).
NIMV with helmet can improve the patient's tolerance, reduce adverse events, increase oxygenation effect, and decrease intubation rate and hospital mortality comparing to face mask. However, the low number of patients from included studies may preclude strong conclusions. Large RCTs are still needed to provide more robust evidence. |
| doi_str_mv | 10.1371/journal.pone.0250063 |
| format | Article |
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English databases included PubMed, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science. Chinese databases involved Wanfang Data, China Knowledge Resource Integrated Database and Chinese Biological Medicine Database. Randomized controlled trials (RCTs) comparing helmet and face mask NIMV for patients with ARF were searched. Meta-analysis was performed using Review manager 5.1.0.
Twelve trials with a total of 569 patients were eligible. Our meta-analysis showed that, comparing with face mask, helmet could significantly decrease the incidences of intolerance [risk ratio (RR) 0.19; 95% confidence interval (CI) 0.09-0.39], facial skin ulcer (RR 0.19; 95% CI 0.08-0.43) and aerophagia (RR 0.15; 95% CI 0.06-0.37), reduce respiratory rate [mean difference (MD) -3.10; 95% CI -4.85 to -1.34], intubation rate (RR 0.39; 95% CI 0.26-0.59) and hospital mortality (RR 0.62; 95% CI 0.39-0.99) in patients with ARF, and improve oxygenation index in patients with hypoxemic ARF (MD 55.23; 95% CI 31.37-79.09). However, subgroupanalysis for hypercapnic ARF revealed that PaCO2 was significantly reduced in face mask group compared with helmet group (MD 5.34; 95% CI 3.41-7.27).
NIMV with helmet can improve the patient's tolerance, reduce adverse events, increase oxygenation effect, and decrease intubation rate and hospital mortality comparing to face mask. However, the low number of patients from included studies may preclude strong conclusions. Large RCTs are still needed to provide more robust evidence.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0250063</identifier><identifier>PMID: 33857228</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acute respiratory distress syndrome ; Artificial respiration ; Bias ; Biology and Life Sciences ; Carbon dioxide ; Care and treatment ; Chronic obstructive pulmonary disease ; Collaboration ; Comparative analysis ; Continuous positive airway pressure ; Disease ; Failure analysis ; Helmets ; Hospitals ; Intensive care ; Intolerance ; Intubation ; Lung diseases ; Mechanical ventilation ; Medicine and Health Sciences ; Meta-analysis ; Mortality ; Obstructive lung disease ; Oxygenation ; Partial pressure ; Physical Sciences ; Physiological aspects ; Pressure ; Protective equipment ; Research and Analysis Methods ; Respiration ; Respiratory distress syndrome ; Respiratory failure ; Respiratory rate ; Respiratory tract ; Safety and security measures ; Software reviews ; Systematic review ; Ventilation ; Ventilators</subject><ispartof>PloS one, 2021-04, Vol.16 (4), p.e0250063-e0250063</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Hong et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Hong et al 2021 Hong et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-c19dafcddba0b999409c569e492c05b289c9c277923f080b30bfc24b941c9953</citedby><cites>FETCH-LOGICAL-c692t-c19dafcddba0b999409c569e492c05b289c9c277923f080b30bfc24b941c9953</cites><orcidid>0000-0003-1956-049X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8049716/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8049716/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23847,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33857228$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Cortegiani, Andrea</contributor><creatorcontrib>Hong, Shukun</creatorcontrib><creatorcontrib>Wang, Hongye</creatorcontrib><creatorcontrib>Tian, Yonggang</creatorcontrib><creatorcontrib>Qiao, Lujun</creatorcontrib><title>The roles of noninvasive mechanical ventilation with helmet in patients with acute respiratory failure: A systematic review and meta-analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To compare the safety and effectiveness between helmet and face mask noninvasive mechanical ventilation (NIMV) in patients with acute respiratory failure (ARF).
English databases included PubMed, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science. Chinese databases involved Wanfang Data, China Knowledge Resource Integrated Database and Chinese Biological Medicine Database. Randomized controlled trials (RCTs) comparing helmet and face mask NIMV for patients with ARF were searched. Meta-analysis was performed using Review manager 5.1.0.
Twelve trials with a total of 569 patients were eligible. Our meta-analysis showed that, comparing with face mask, helmet could significantly decrease the incidences of intolerance [risk ratio (RR) 0.19; 95% confidence interval (CI) 0.09-0.39], facial skin ulcer (RR 0.19; 95% CI 0.08-0.43) and aerophagia (RR 0.15; 95% CI 0.06-0.37), reduce respiratory rate [mean difference (MD) -3.10; 95% CI -4.85 to -1.34], intubation rate (RR 0.39; 95% CI 0.26-0.59) and hospital mortality (RR 0.62; 95% CI 0.39-0.99) in patients with ARF, and improve oxygenation index in patients with hypoxemic ARF (MD 55.23; 95% CI 31.37-79.09). However, subgroupanalysis for hypercapnic ARF revealed that PaCO2 was significantly reduced in face mask group compared with helmet group (MD 5.34; 95% CI 3.41-7.27).
NIMV with helmet can improve the patient's tolerance, reduce adverse events, increase oxygenation effect, and decrease intubation rate and hospital mortality comparing to face mask. However, the low number of patients from included studies may preclude strong conclusions. Large RCTs are still needed to provide more robust evidence.</description><subject>Acute respiratory distress syndrome</subject><subject>Artificial respiration</subject><subject>Bias</subject><subject>Biology and Life Sciences</subject><subject>Carbon dioxide</subject><subject>Care and treatment</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Collaboration</subject><subject>Comparative analysis</subject><subject>Continuous positive airway pressure</subject><subject>Disease</subject><subject>Failure analysis</subject><subject>Helmets</subject><subject>Hospitals</subject><subject>Intensive care</subject><subject>Intolerance</subject><subject>Intubation</subject><subject>Lung diseases</subject><subject>Mechanical ventilation</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Mortality</subject><subject>Obstructive lung disease</subject><subject>Oxygenation</subject><subject>Partial pressure</subject><subject>Physical Sciences</subject><subject>Physiological aspects</subject><subject>Pressure</subject><subject>Protective equipment</subject><subject>Research and Analysis Methods</subject><subject>Respiration</subject><subject>Respiratory distress syndrome</subject><subject>Respiratory failure</subject><subject>Respiratory rate</subject><subject>Respiratory tract</subject><subject>Safety and security measures</subject><subject>Software reviews</subject><subject>Systematic 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roles of noninvasive mechanical ventilation with helmet in patients with acute respiratory failure: A systematic review and meta-analysis</title><author>Hong, Shukun ; Wang, Hongye ; Tian, Yonggang ; Qiao, Lujun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-c19dafcddba0b999409c569e492c05b289c9c277923f080b30bfc24b941c9953</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acute respiratory distress syndrome</topic><topic>Artificial respiration</topic><topic>Bias</topic><topic>Biology and Life Sciences</topic><topic>Carbon dioxide</topic><topic>Care and treatment</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Collaboration</topic><topic>Comparative analysis</topic><topic>Continuous positive airway pressure</topic><topic>Disease</topic><topic>Failure analysis</topic><topic>Helmets</topic><topic>Hospitals</topic><topic>Intensive 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meta-analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-04-15</date><risdate>2021</risdate><volume>16</volume><issue>4</issue><spage>e0250063</spage><epage>e0250063</epage><pages>e0250063-e0250063</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To compare the safety and effectiveness between helmet and face mask noninvasive mechanical ventilation (NIMV) in patients with acute respiratory failure (ARF).
English databases included PubMed, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science. Chinese databases involved Wanfang Data, China Knowledge Resource Integrated Database and Chinese Biological Medicine Database. Randomized controlled trials (RCTs) comparing helmet and face mask NIMV for patients with ARF were searched. Meta-analysis was performed using Review manager 5.1.0.
Twelve trials with a total of 569 patients were eligible. Our meta-analysis showed that, comparing with face mask, helmet could significantly decrease the incidences of intolerance [risk ratio (RR) 0.19; 95% confidence interval (CI) 0.09-0.39], facial skin ulcer (RR 0.19; 95% CI 0.08-0.43) and aerophagia (RR 0.15; 95% CI 0.06-0.37), reduce respiratory rate [mean difference (MD) -3.10; 95% CI -4.85 to -1.34], intubation rate (RR 0.39; 95% CI 0.26-0.59) and hospital mortality (RR 0.62; 95% CI 0.39-0.99) in patients with ARF, and improve oxygenation index in patients with hypoxemic ARF (MD 55.23; 95% CI 31.37-79.09). However, subgroupanalysis for hypercapnic ARF revealed that PaCO2 was significantly reduced in face mask group compared with helmet group (MD 5.34; 95% CI 3.41-7.27).
NIMV with helmet can improve the patient's tolerance, reduce adverse events, increase oxygenation effect, and decrease intubation rate and hospital mortality comparing to face mask. However, the low number of patients from included studies may preclude strong conclusions. Large RCTs are still needed to provide more robust evidence.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33857228</pmid><doi>10.1371/journal.pone.0250063</doi><orcidid>https://orcid.org/0000-0003-1956-049X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Public Library of Science (PLoS) Journals Open Access; PMC (PubMed Central); Full-Text Journals in Chemistry (Open access); DOAJ Directory of Open Access Journals; EZB Electronic Journals Library |
| subjects | Acute respiratory distress syndrome Artificial respiration Bias Biology and Life Sciences Carbon dioxide Care and treatment Chronic obstructive pulmonary disease Collaboration Comparative analysis Continuous positive airway pressure Disease Failure analysis Helmets Hospitals Intensive care Intolerance Intubation Lung diseases Mechanical ventilation Medicine and Health Sciences Meta-analysis Mortality Obstructive lung disease Oxygenation Partial pressure Physical Sciences Physiological aspects Pressure Protective equipment Research and Analysis Methods Respiration Respiratory distress syndrome Respiratory failure Respiratory rate Respiratory tract Safety and security measures Software reviews Systematic review Ventilation Ventilators |
| title | The roles of noninvasive mechanical ventilation with helmet in patients with acute respiratory failure: A systematic review and meta-analysis |
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