The efficacy of noninvasive positive pressure ventilation on severe stable chronic obstructive pulmonary disease with respiratory failure patients: a meta-analysis of randomized controlled trials_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

WANG Mei , LIAO Hao , PEI Wendi , LI Hongfu , WANG Kai ,  CHEN Xin

Department of Respiratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510282, P. R. China;

Corresponding author：

CHEN Xin, Email: chen_xin1020@163.com

Keywords：

Chronic obstructive pulmonary disease; Meta-analysis; Noninvasive positive pressure ventilation; Mortality; Acute exacerbations

DOI：

10.7507/1671-6205.201705043

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ObjectiveTo assess the mortality, acute exacerbations, exercise capacity, symptoms and significant physiological parameters (lung function, respiratory muscle function and gas exchange) of patients with severe stable chronic obstructive pulmonary disease (COPD) with respiratory failure treated by noninvasive positive pressure ventilation (NPPV).MethodsA meta-analysis of randomized controlled trials was carried out by searching PubMed, Cochrane library, Embase, OVID, Chinese Biomedical Literature Database and the bibliographies of the retrieved articles up to February 2017. Studies of patients with severe stable COPD with respiratory failure receiving long-term noninvasive positive pressure ventilation and comparison with oxygen therapy were conducted, and at least one of the following parameters were reviewed: frequency of acute exacerbations, mortality, lung function, respiratory muscle function, gas exchange, 6-minute walk test.ResultsSix studies with 695 subjects met the inclusion criteria and were analyzed. The PaCO₂ was significantly decreased in patients who received long-term NPPV. No significant difference was found between long-term NPPV and oxygen therapy in mortality, frequency of acute exacerbations, gas exchange, lung function, respiratory muscle function and exercise capacity. The subgroup analysis showed that NPPV improves survival of patients when it is targeted at greatly reducing hypercapnia.ConclusionCurrent evidence suggests that there is no significant improvement by application of NPPV on severe stable COPD with respiratory failure patients, but NPPV may reduce patients’ mortality with the aim of reducing hypercapnia.

Citation： WANG Mei, LIAO Hao, PEI Wendi, LI Hongfu, WANG Kai, CHEN Xin. The efficacy of noninvasive positive pressure ventilation on severe stable chronic obstructive pulmonary disease with respiratory failure patients: a meta-analysis of randomized controlled trials. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(3): 223-229. doi: 10.7507/1671-6205.201705043 Copy

1.	Ojo O, Lagan AL, Rajendran V, et al. Pathological changes in the COPD lung mesenchyme - novel lessons learned from invitro, and in vivo studies. Pulm Pharmacol Ther, 2014, 29(2): 121-128.
2.	Decramer M, Janssens W, Miravitlles M. Chronic obstructive pulmonary disease. Lancet, 2012, 379(9823): 1341-1351.
3.	Tan WC, Mahayiddin AA, Charoenratanakul S, et al. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease (update 2014) Global Initiative for Chronic Obstructive Lung Disease 2014 GOLD. Respirology, 2005, 10(1): 9-17.
4.	Foucher P, Baudouin N, Merati M, et al. Relative survival analysis of 252 patients with COPD receiving long-term oxygen therapy. Chest, 1998, 113(6): 1580-1587.
5.	Seemungal T, Donaldson GE, Bestall J, et al. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 1998, 157(1): 1418-1422.
6.	Windisch W, Kostić S, Dreher M, et al. Outcome of patients with stable COPD receiving controlled noninvasive positive pressure ventilation aimed at a maximal reduction of PaCO₂. Chest, 2005, 128(2): 657-662.
7.	Anonymous. Clinical indications for noninvasive positive pressure ventilation in chronic respiratory failure due to restrictive lung disease, COPD, and nocturnal hypoventilation - a consensus conference report. Chest, 1999, 116(2): 521-534.
8.	Mehta S, Hill NS. Noninvasive ventilation. Am J Respir Crit Care Med, 2001, 163(2): 540-577.
9.	Tuggey JM, Plant PK, Elliott MW. Domiciliary non-invasive ventilation for recurrent acidotic exacerbations of COPD: an economic analysis. Thorax, 2003, 58(10): 867-871.
10.	Struik FM, Lacasse Y, Goldstein RS, et al. Nocturnal noninvasive positive pressure ventilation in stable COPD: a systematic review and individual patient data meta-analysis. Resp Med, 2014, 108(2): 329-337.
11.	Struik FM, Sprooten RT, Kerstjens HA, et al. Nocturnal non-invasive ventilation in COPD patients with prolonged hypercapnia after ventilatory support for acute respiratory failure: a randomised, controlled, parallel-group study. Thorax, 2014, 69(9): 826-834.
12.	Köhnlein T, Windisch W, Köhler D, et al. Non-invasive positive pressure ventilation for the treatment of severe stable chronic obstructive pulmonary disease: a prospective, multicentre, randomised, controlled clinical trial. Lancet Respir Med, 2014, 2(9): 698-705.
13.	Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global strategy for the diagnosis, management and prevention of chronic obstructive lung disease 2017 report. Am J Respir Crit Care, 2017, 195(5):557-582.
14.	Oana S, Mukherji J. Acute and chronic respiratory failure. Handb Clin Neurol, 2014, 119:273-288.
15.	Higgins JPT, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 2011, 343: d5928-d5928.
16.	Lau J, Ioannidis JP, Schmid CH. Quantitative synthesis in systematic reviews. Ann Intern Med, 1997, 127(9): 820-826.
17.	Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ, 2003, 327: 557-560.
18.	Su CL, Chiang LL, Chiang TY, et al. Domiciliary positive expiratory pressure improves pulmonary function and exercise capacity in patients with chronic obstructive pulmonary disease. J Formos Med Assoc, 2007, 106(3): 204-211.
19.	Gurgun A, Tuncel S, Karapolat H, et al. The effect of adding noninvasive ventilation to supplemental oxygen during exercise training in severe COPD: a randomized controlled study. Chest, 2015, 148(4): 909A-909A.
20.	Díaz O, Bégin P, Torrealba B, et al. Effects of noninvasive ventilation on lung hyperinflation in stable hypercapnic COPD. Eur Respir J, 2002, 20(6): 1490-1498.
21.	Díaz O, Bégin P, Andresen M, et al. Physiological and clinical effects of diurnal noninvasive ventilation in hypercapnic COPD. Eur Respir J, 2005, 26(6): 1016-1023.
22.	van 't Hul A, Gosselink R, Hollander P, et al. Training with inspiratory pressure support in patients with severe COPD. Eur Respir J, 2006, 27(1): 65-72.
23.	Sin DD, Wong E, Mayers I, et al. Effects of nocturnal noninvasive mechanical ventilation on heart rate variability of patients with advanced COPD. Chest, 2007, 131(1): 156-163.
24.	McEvoy RD, Pierce RJ, Hillman D, et al. Nocturnal non-invasive nasal ventilation in stable hypercapnic COPD: a randomised controlled trial. Thorax, 2009, 64(7): 561-566.
25.	Clini E, Sturani C, Rossi A, et al. The Italian multicentre study on noninvasive ventilation in chronic obstructive pulmonary disease patients. Eur Respir J, 2002, 20(3): 529-538.
26.	Casanova C, Celli BR, Tost L, et al. Long-term controlled trial of nocturnal nasal positive pressure ventilation in patients with severe COPD. Chest, 2000, 118(6): 1582-1590.
27.	Gay PC, Hubmayr RD, Stroetz RW. Efficacy of nocturnal nasal ventilation in stable, severe chronic obstructive pulmonary disease during a 3-month controlled trial. Mayo Clin Proc, 1996, 71(6): 533-542.
28.	Matkovic Z, Huerta A, Soler N, et al. Predictors of adverse outcome in patients hospitalised for exacerbation of chronic obstructive pulmonary disease. Respiration, 2012, 84(1): 17-26.
29.	Cooper CB, Waterhouse J, Howard P. Twelve year clinical study of patients with hypoxic corpulmonale given long term domiciliary oxygen therapy. Thorax, 1987, 42(2): 105-110.
30.	Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions. N-S Arch Pharmacol, 2008, 5(2): S38.
31.	Klimathianaki M, Vaporidi K, Georgopoulos D. Respiratory muscle dysfunction in COPD: from muscles to cell. Curr Drug Targets, 2011, 12(4): 478-488.
32.	Juan G, Calverley P, Talamo C, et al. Effect of carbon dioxide on diaphragmatic function in human beings. N Engl J Med, 1984, 310(14): 874-879.
33.	Wedzicha JA, Muir JF. Noninvasive ventilation in chronic obstructive pulmonary disease, bronchiectasis and cystic fibrosis. Eur Respir J, 2002, 20(3): 777-784.
34.	Schucher B, Zerbst J, Baumann HJ. Noninvasive mechanical ventilation in patients with stable severe COPD. Pneumologie, 2004, 58(6): 428-434.
35.	Windisch W, Vogel M, Sorichter S, et al. Normocapnia during nIPPV in chronic hypercapnic COPD reduces subsequent spontaneous PaCO₂. Resp Med, 2002, 96(8): 572-579.

1. Ojo O, Lagan AL, Rajendran V, et al. Pathological changes in the COPD lung mesenchyme - novel lessons learned from invitro, and in vivo studies. Pulm Pharmacol Ther, 2014, 29(2): 121-128.
2. Decramer M, Janssens W, Miravitlles M. Chronic obstructive pulmonary disease. Lancet, 2012, 379(9823): 1341-1351.
3. Tan WC, Mahayiddin AA, Charoenratanakul S, et al. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease (update 2014) Global Initiative for Chronic Obstructive Lung Disease 2014 GOLD. Respirology, 2005, 10(1): 9-17.
4. Foucher P, Baudouin N, Merati M, et al. Relative survival analysis of 252 patients with COPD receiving long-term oxygen therapy. Chest, 1998, 113(6): 1580-1587.
5. Seemungal T, Donaldson GE, Bestall J, et al. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 1998, 157(1): 1418-1422.
6. Windisch W, Kostić S, Dreher M, et al. Outcome of patients with stable COPD receiving controlled noninvasive positive pressure ventilation aimed at a maximal reduction of PaCO₂. Chest, 2005, 128(2): 657-662.
7. Anonymous. Clinical indications for noninvasive positive pressure ventilation in chronic respiratory failure due to restrictive lung disease, COPD, and nocturnal hypoventilation - a consensus conference report. Chest, 1999, 116(2): 521-534.
8. Mehta S, Hill NS. Noninvasive ventilation. Am J Respir Crit Care Med, 2001, 163(2): 540-577.
9. Tuggey JM, Plant PK, Elliott MW. Domiciliary non-invasive ventilation for recurrent acidotic exacerbations of COPD: an economic analysis. Thorax, 2003, 58(10): 867-871.
10. Struik FM, Lacasse Y, Goldstein RS, et al. Nocturnal noninvasive positive pressure ventilation in stable COPD: a systematic review and individual patient data meta-analysis. Resp Med, 2014, 108(2): 329-337.
11. Struik FM, Sprooten RT, Kerstjens HA, et al. Nocturnal non-invasive ventilation in COPD patients with prolonged hypercapnia after ventilatory support for acute respiratory failure: a randomised, controlled, parallel-group study. Thorax, 2014, 69(9): 826-834.
12. Köhnlein T, Windisch W, Köhler D, et al. Non-invasive positive pressure ventilation for the treatment of severe stable chronic obstructive pulmonary disease: a prospective, multicentre, randomised, controlled clinical trial. Lancet Respir Med, 2014, 2(9): 698-705.
13. Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global strategy for the diagnosis, management and prevention of chronic obstructive lung disease 2017 report. Am J Respir Crit Care, 2017, 195(5):557-582.
14. Oana S, Mukherji J. Acute and chronic respiratory failure. Handb Clin Neurol, 2014, 119:273-288.
15. Higgins JPT, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 2011, 343: d5928-d5928.
16. Lau J, Ioannidis JP, Schmid CH. Quantitative synthesis in systematic reviews. Ann Intern Med, 1997, 127(9): 820-826.
17. Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ, 2003, 327: 557-560.
18. Su CL, Chiang LL, Chiang TY, et al. Domiciliary positive expiratory pressure improves pulmonary function and exercise capacity in patients with chronic obstructive pulmonary disease. J Formos Med Assoc, 2007, 106(3): 204-211.
19. Gurgun A, Tuncel S, Karapolat H, et al. The effect of adding noninvasive ventilation to supplemental oxygen during exercise training in severe COPD: a randomized controlled study. Chest, 2015, 148(4): 909A-909A.
20. Díaz O, Bégin P, Torrealba B, et al. Effects of noninvasive ventilation on lung hyperinflation in stable hypercapnic COPD. Eur Respir J, 2002, 20(6): 1490-1498.
21. Díaz O, Bégin P, Andresen M, et al. Physiological and clinical effects of diurnal noninvasive ventilation in hypercapnic COPD. Eur Respir J, 2005, 26(6): 1016-1023.
22. van 't Hul A, Gosselink R, Hollander P, et al. Training with inspiratory pressure support in patients with severe COPD. Eur Respir J, 2006, 27(1): 65-72.
23. Sin DD, Wong E, Mayers I, et al. Effects of nocturnal noninvasive mechanical ventilation on heart rate variability of patients with advanced COPD. Chest, 2007, 131(1): 156-163.
24. McEvoy RD, Pierce RJ, Hillman D, et al. Nocturnal non-invasive nasal ventilation in stable hypercapnic COPD: a randomised controlled trial. Thorax, 2009, 64(7): 561-566.
25. Clini E, Sturani C, Rossi A, et al. The Italian multicentre study on noninvasive ventilation in chronic obstructive pulmonary disease patients. Eur Respir J, 2002, 20(3): 529-538.
26. Casanova C, Celli BR, Tost L, et al. Long-term controlled trial of nocturnal nasal positive pressure ventilation in patients with severe COPD. Chest, 2000, 118(6): 1582-1590.
27. Gay PC, Hubmayr RD, Stroetz RW. Efficacy of nocturnal nasal ventilation in stable, severe chronic obstructive pulmonary disease during a 3-month controlled trial. Mayo Clin Proc, 1996, 71(6): 533-542.
28. Matkovic Z, Huerta A, Soler N, et al. Predictors of adverse outcome in patients hospitalised for exacerbation of chronic obstructive pulmonary disease. Respiration, 2012, 84(1): 17-26.
29. Cooper CB, Waterhouse J, Howard P. Twelve year clinical study of patients with hypoxic corpulmonale given long term domiciliary oxygen therapy. Thorax, 1987, 42(2): 105-110.
30. Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions. N-S Arch Pharmacol, 2008, 5(2): S38.
31. Klimathianaki M, Vaporidi K, Georgopoulos D. Respiratory muscle dysfunction in COPD: from muscles to cell. Curr Drug Targets, 2011, 12(4): 478-488.
32. Juan G, Calverley P, Talamo C, et al. Effect of carbon dioxide on diaphragmatic function in human beings. N Engl J Med, 1984, 310(14): 874-879.
33. Wedzicha JA, Muir JF. Noninvasive ventilation in chronic obstructive pulmonary disease, bronchiectasis and cystic fibrosis. Eur Respir J, 2002, 20(3): 777-784.
34. Schucher B, Zerbst J, Baumann HJ. Noninvasive mechanical ventilation in patients with stable severe COPD. Pneumologie, 2004, 58(6): 428-434.
35. Windisch W, Vogel M, Sorichter S, et al. Normocapnia during nIPPV in chronic hypercapnic COPD reduces subsequent spontaneous PaCO₂. Resp Med, 2002, 96(8): 572-579.

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The efficacy of noninvasive positive pressure ventilation on severe stable chronic obstructive pulmonary disease with respiratory failure patients: a meta-analysis of randomized controlled trials

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