Use Of Noninvasive Ventilation In Adult With Acute Respiratory Distress Syndrome:a Meta-analysis

Objective:To systematically assess of the influence of noninvasive ventilation (NIV) on the rate of endotracheal intubation and intensive care unit(ICU) mortality in patients with acute respiratory distress syndrome (ARDS). Methods:The database of PubMed, MEDLINE, Embase, The Cochrane center register of controlled trials, the CNKI and the Wanfang biomedicine were searched to identify prospective randomized controlled trials (RCTs) on NIV treating ARDS adult patients extensively. Search time limited from 1995 to 2014. Languages were English and Chinese limited. Made the conclusion standards and exclusion standards, evaluated the quality of literature and extracted data and the Cochrane Collaboration RevMan 5.3 was used for data analysis. Results:A total of 6 studies enrolling 443 patients were included,222 of them were accepted NIV treating,221 of them were accepted common oxygen therapy. Subgroup A has four RCTs (BiPAP vs. conventional oxygen cure); subgroup B has two RCTs (CPAP vs. conventional oxygen cure).In subgroup A, BiPAP was found to be associated with a lower endotracheal intubation (RR=032,95%CI:0.23～0.47,P<0.05) and a lower ICU mortality (RR=0.43, 95%CI:0.28～0.66,P<0.05) in adult ARDS patients. In subgroup B, it was found the differences in endotracheal intubation (RR=0.39,95%CI:0.06～2.43, P=0.31) and ICU mortality (RR=0.44,95%CI:0.11～1.84, P=0.26) were not significant. Conclusion: Compared with common oxygen therapy, NTV can reduce the rate of endotracheal intubation and intensive care unit (ICU) mortality in adult patients with early acute respiratory distress syndrome (ARDS).