| Title |
Noninvasive ventilation with helmet versus control strategy in patients with acute respiratory failure: a systematic review and meta-analysis of controlled studies
|
|---|---|
| Published in |
Critical Care, August 2016
|
| DOI | 10.1186/s13054-016-1449-4 |
| Pubmed ID | |
| Authors |
Qi Liu, Yonghua Gao, Rongchang Chen, Zhe Cheng |
| Abstract |
Noninvasive ventilation (NIV) has proved to be a useful technique for breathing support. However, complications, discomfort, and failure of NIV were commonly caused by the mask. Therefore, the helmet was developed to improve performance and reduce complications; however, there has been no conclusive results on its effect until now. Thus, we performed a systematic review and meta-analysis to investigate the effect of NIV with a helmet versus the control strategy in patients with acute respiratory failure (ARF). We searched Cochrane Library, PubMed, Ovid, and Embase databases and bibliographies of relevant articles published before June 2016. Randomized and case-control studies that adopted the helmet as an NIV interface and compared it with another interface were included. The primary outcomes were hospital mortality, intubation rate, and complications. The secondary outcomes included the length of intensive care unit (ICU) stay, gas exchange, and respiratory rate. Pooled odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated by the Mantel-Haenszel method and mean difference by the inverse variance method in a fixed effect model or random effects model according to the heterogeneity. A total of 11 studies involving 621 patients were included. The overall hospital mortality was 17.53 % in the helmet NIV group versus 30.67 % in the control group. Use of the helmet was associated with lower hospital mortality (OR 0.43, 95 % CI 0.26 to 0.69, p = 0.0005), intubation rate (OR 0.32, 95 % CI 0.21 to 0.47, P < 0.00001), and complications (OR 0.6, 95 % CI 0.4 to 0.92, P = 0.02). In contrast, there was no significant difference in gas exchange and ICU stay (P >0.05). Subgroup analysis found the helmet reduced mortality mainly in hypoxemic ARF patients (P < 0.05) and a lower intubation rate was shown in randomized trials; fewer complications caused by the helmet might be restricted to case-control trials. Additionally, the effect of the helmet on PaCO2 was influenced by type of ARF and ventilation mode (P <0.00001). NIV with a helmet was associated with reduced hospital mortality and intubation requirement. The helmet was as effective as the mask in gas exchange with no additional advantage. Large randomized controlled trials are needed to provide more robust evidence. |
X Demographics
The data shown below were collected from the profiles of 77 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 10 | 13% |
| Australia | 6 | 8% |
| Canada | 4 | 5% |
| Malaysia | 4 | 5% |
| Italy | 4 | 5% |
| Colombia | 3 | 4% |
| Mexico | 3 | 4% |
| Spain | 3 | 4% |
| Saudi Arabia | 2 | 3% |
| Other | 13 | 17% |
| Unknown | 25 | 32% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 51 | 66% |
| Practitioners (doctors, other healthcare professionals) | 18 | 23% |
| Scientists | 5 | 6% |
| Science communicators (journalists, bloggers, editors) | 3 | 4% |
Mendeley readers
The data shown below were compiled from readership statistics for 122 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | <1% |
| Unknown | 121 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 17 | 14% |
| Student > Bachelor | 11 | 9% |
| Other | 10 | 8% |
| Student > Postgraduate | 9 | 7% |
| Student > Master | 9 | 7% |
| Other | 22 | 18% |
| Unknown | 44 | 36% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 50 | 41% |
| Nursing and Health Professions | 12 | 10% |
| Biochemistry, Genetics and Molecular Biology | 4 | 3% |
| Engineering | 2 | 2% |
| Social Sciences | 2 | 2% |
| Other | 3 | 2% |
| Unknown | 49 | 40% |
Attention Score in Context
This research output has an Altmetric Attention Score of 51. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 September 2020.
All research outputs
#830,667
of 25,373,627 outputs
Outputs from Critical Care
#624
of 6,554 outputs
Outputs of similar age
#15,809
of 354,257 outputs
Outputs of similar age from Critical Care
#25
of 104 outputs
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