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http://dx.doi.org/10.4046/trd.2021.0062

The Long-term Efficacy of Domiciliary Noninvasive Positive-Pressure Ventilation in Chronic Obstructive Pulmonary Disease: A Meta-Analysis of Randomized Controlled Trials  

Park, So Young (Department of Internal Medicine, Ewha Womans University College of Medicine)
Yoo, Kwang Ha (Department of Internal Medicine, Konkuk University School of Medicine)
Park, Yong Bum (Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kandong Sacred Heart Hospital)
Rhee, Chin Kook (Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea)
Park, Jinkyeong (Division of Pulmonary, Department of Internal Medicine, Dongguk University College of Medicine)
Park, Hye Yun (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Hwang, Yong Il (Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital)
Park, Dong Ah (Division of Healthcare Technology Assessment Research, Office of Health Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency)
Sim, Yun Su (Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital)
Publication Information
Tuberculosis and Respiratory Diseases / v.85, no.1, 2022 , pp. 47-55 More about this Journal
Abstract
Background: We evaluated the long-term effects of domiciliary noninvasive positive-pressure ventilation (NIPPV) used to treat patients with chronic obstructive pulmonary disease (COPD). Methods: Databases were searched to identify randomized controlled trials of COPD with NIPPV for longer than 1 year. Mortality rates were the primary outcome in this meta-analysis. The eight trials included in this study comprised data from 913 patients. Results: The mortality rates for the NIPPV and control groups were 29% (118/414) and 36% (151/419), suggesting a statistically significant difference (risk ratio [RR], 0.79; 95% confidence interval [CI], 0.65-0.95). Mortality rates were reduced with NIPPV in four trials that included stable COPD patients. There was no difference in admission, acute exacerbation and quality of life between the NIPPV and control groups. There was no significant difference in withdrawal rates between the two groups (RR, 0.99; 95% CI, 0.72-1.36; p=0.94). Conclusion: Maintaining long-term nocturnal NIPPV for more than 1 year, especially in patients with stable COPD, decreased the mortality rate, without increasing the withdrawal rate compared with long-term oxygen treatment.
Keywords
Noninvasive Positive-Pressure Ventilation; Chronic Obstructive Pulmonary Disease; Mortality;
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