Effects of different oxygen therapies on conservative treatment of spontaneous pneumothorax: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CAO Xiong ^1,2 , LI Xiuxia ^3,4,5 , LIN Ruijiang ² ,  YANG Kehu ^4,5 ,  HAN Biao ²

1. First Clinical Medical College, Lanzhou University, Lanzhou, 730000, P.R.China;
2. First Hospital, Lanzhou University, Lanzhou, 730000, P.R.China;
3. School of Public Health, Lanzhou University, Lanzhou, 730000, P.R.China;
4. Evidence-based Medicine Center, Lanzhou University/School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, P.R.China;
5. The Key Laboratory of Evidence-based Medicine and Clinical Transformation, Gansu Province, Lanzhou, 730000, P.R.China;

Corresponding author：

YANG Kehu, Email: kehuyangebm2006@126.com; HAN Biao, Email: hanbiao66@163.com

Keywords：

Spontaneous pneumothorax; oxygen therapy; meta-analysis; randomized controlled trial

DOI：

10.7507/1007-4848.201804050

Video：

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Objective To investigate the effects of two different oxygen therapies (oxygen time<4 h/d, oxygen flow>6 L/min versus oxygen time>4 h/d, oxygen flow<6 L/min) on conservative treatment of spontaneous pneumothorax by meta-analysis.Methods The following electronic databases as PubMed, The Cochrane Library, Web of Science, Chinese Biomedical Literature Database, WanFang Database and China National Knowledge Database were retrieved on computer for randomized controlled trials (RCTs) of comparing two different oxygen therapies (oxygen time<4 h/d, oxygen flow>6 L/min versus oxygen time>4 h/d, oxygen flow<6 L/min) on conservative treatment of spontaneous pneumothorax. The retrieval time was from inception of each database to December 2017. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then data were analyzed by RevMan 5.3 software.Results A total of 4 RCTs involving 226 patients were included. The meta-analysis showed that compared with lower oxygen flow (oxygen time>4 h/d, oxygen flow<6 L/min), the higher oxygen flow (oxygen time<4 h/d, oxygen flow>6 L/min) could obviously decrease the degree of pulmonary compression after oxygen therapy for 5 days (MD=–2.81, 95%CI –4.18 to –1.44, P<0.05), shorten duration of hospital stay (MD=–3.26, 95%CI –6.05 to –0.47, P<0.05) and duration of recruitment maneuvers (MD=–2.78, 95%CI –5.27 to –0.28, P<0.05), but there was no significant difference in oxygen partial pressure after oxygen therapy for 5 days (MD=10.68, 95%CI –7.03 to 28.39, P=0.24).Conclusion The higher oxygen flow (oxygen time<4 h/d, oxygen flow>6 L/min) can obviously decrease the degree of pulmonary compression after oxygen therapy for 5 days, shorten duration of hospital stay and duration of recruitment maneuvers, but the results are influenced by the number and quality of RCT.

Citation： CAO Xiong, LI Xiuxia, LIN Ruijiang, YANG Kehu, HAN Biao. Effects of different oxygen therapies on conservative treatment of spontaneous pneumothorax: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(3): 245-250. doi: 10.7507/1007-4848.201804050 Copy

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3.	Sahn SA, Heffner JE. Spontaneous pneumothorax. N Engl J Med, 2000, 342(12): 868-874.
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9.	Voge VM, Anthracite R. Spontaneous pneumothorax in the USAF aircrew population: a retrospective study. Aviat Space Environ Med, 1986, 57(10 Pt 1): 939-949.
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17.	彭员秀, 刘华敏. 不同氧流量治疗慢性阻塞性肺疾病合并气胸的临床观察. 护理实践与研究, 2013, 10(4): 56-57.
18.	胡文滕, 蔺瑞江, 滕元军等. 中国循证医学杂志, 2014, 14(8): 927-933.
19.	姚伟, 钱桂生. 胸膜疾病诊断治疗新观点(气胸的处理). 中国实用内科杂志, 2008, 2(2): 81-83.
20.	唐琴琴, 徐丁, 田金徽, 等. 早产儿经鼻高流量氧疗安全性和有效性的系统评价和 Meta 分析. 中国循证儿科杂志, 2017, 10(3): 175-179.
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23.	肖献忠, 主编. 病理生理学. 第 3 版. 高等教育出版社, 2013. 80.

1. 白明, 主译. 现代肺部疾病诊断与治疗. 北京: 人民卫生出版社, 2006: 189.
2. MacDuff A, Arnold A, Harvey J. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax, 2010, 65(Suppl 2): ii18-ii31.
3. Sahn SA, Heffner JE. Spontaneous pneumothorax. N Engl J Med, 2000, 342(12): 868-874.
4. Lichter J, Gwynne JF. Spontaneous pneumothorax in young subjects. Thorax, 1971, 25(3): 409-417.
5. Light RW. Management of spontaneous pneumothorax. Am Rev Respir Dis, 1993, 148(1): 245-258.
6. Baumann MH, Strange C, Heffner JE, et al. Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest, 2001, 119(2): 590-602.
7. Seremetis MG. The management of spontaneous pneumothorax. Chest, 1970, 57(1): 65-68.
8. Gobbel WG Jr, Rhea WG Jr. Spontaneous pneumothorax. J Thorac Cardiovasc Surg, 1963, 46(3): 331-345.
9. Voge VM, Anthracite R. Spontaneous pneumothorax in the USAF aircrew population: a retrospective study. Aviat Space Environ Med, 1986, 57(10 Pt 1): 939-949.
10. Tschopp JM, Rami-Porta R, Noppen M, et al. Management of spontaneous pneumothorax: state of the art. Eur Respir J, 2006, 28(3): 637-650.
11. Kelly A. Treatment of primary spontaneous pneumothorax. Curr Opin Pulm Med, 2009, 15(4): 376-379.
12. 陈灏珠, 主编. 实用内科学. 第 12 版. 北京: 人民卫生出版社, 2005.
13. 董敬军, 陈建荣, 陈金亮, 等. 不同吸氧方法治疗自发性气胸效果比较. 实用医院临床杂志, 2010, 7(5): 74-76.
14. 陈央, 梁宗安, 陈军. 高浓度吸氧及胸穿抽气治疗大学生特发性稳定型小量气胸. 西部医学, 2017, 29(4): 484-488.
15. Julian PT Higgins. Sally Green. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). Available at: http://handbook.cochrane.org/.
16. 鲍凤. 氧疗在自发性气胸患者中的应用与护理. 安徽医药, 2012, 16(6): 863-864.
17. 彭员秀, 刘华敏. 不同氧流量治疗慢性阻塞性肺疾病合并气胸的临床观察. 护理实践与研究, 2013, 10(4): 56-57.
18. 胡文滕, 蔺瑞江, 滕元军等. 中国循证医学杂志, 2014, 14(8): 927-933.
19. 姚伟, 钱桂生. 胸膜疾病诊断治疗新观点(气胸的处理). 中国实用内科杂志, 2008, 2(2): 81-83.
20. 唐琴琴, 徐丁, 田金徽, 等. 早产儿经鼻高流量氧疗安全性和有效性的系统评价和 Meta 分析. 中国循证儿科杂志, 2017, 10(3): 175-179.
21. Henry M, Arnold T, Harvey J, et al. BTS guidelines for the management of spontaneous pneumothorax. Thorax, 2003, 58(Suppl II): ii39-ji52.
22. Dharmeshkumar N, Ashish G, Agarwal S, et al. Oxygen toxicity. JI- ACM, 2003, 4(3): 234-237.
23. 肖献忠, 主编. 病理生理学. 第 3 版. 高等教育出版社, 2013. 80.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Effects of different oxygen therapies on conservative treatment of spontaneous pneumothorax: A systematic review and meta-analysis

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