The role of non-invasive ventilation used immediately after planned extubation for adults with chronic respiratory disorders.

OBJECTIVE:  To estimate the benefits of non-invasive ventilation (NIV) used immediately after planned postextubation in patients with chronic respiratory disorders.

METHODS:  Cochrane Library, PubMed, the Chinese BioMedical Literature Database of clinical trials (CBD) and Embase were searched for pertinent studies by 2 trained investigators. Pooled odds ratios and 95% confidence intervals (CIs) were calculated by employing both fixed-effects and random-effects models.

RESULTS:  Eight studies enrolling 736 patients were included in the meta-analysis. Compared with general oxygen therapy, NIV used immediately after planned extubation in patients with chronic respiratory disease reduced the reintubation rate (p=0.02), ventilator-associated pneumonia (VAP) incidence rate (p=0.000), and ICU mortality (p=0.002) and increased the level of PO2 (p=0.03).

CONCLUSION:  Non-invasive ventilation used immediately after planned extubation seems to be advantageous for decreasing the reintubation rate, VAP incidence, and ICU death rate in patients with chronic respiratory disease.