National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China.
Department of Pulmonary and Critical Care Medicine, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Int J Infect Dis. 2021 May;106:254-261. doi: 10.1016/j.ijid.2021.03.078. Epub 2021 Mar 30.
Guidelines from different regions on the use of non-invasive ventilation in COVID-19 have generally been inconsistent. The aim of this systematic review was to appraise the quality and availability of guidelines, and whether non-invasive ventilation in the early stages of the pandemic is of importance.
Databases, including PubMed, Web of Science, and Cochrane Library, as well as websites of international organizations and gray literature, were searched up to June 23, 2020. The reference lists of eligible papers were also hand-searched.
A total of 26 guidelines met the inclusion criteria. According to the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, the guidelines' methodological quality was low. Among six domains, Rigour of Development and Editorial Independence were of the lowest quality. Given the lack of evidence from randomized clinical trials and the great variation between different regions, recommendations for non-invasive ventilation have generated considerable debate regarding the early stages of COVID-19.
Improving the methodological quality of the guidelines should be a goal with regard to future pandemics. Additionally, better-designed randomized clinical trials are needed to resolve contradictions regarding the impact of non-invasive ventilation.
CRD42020198410.
不同地区关于 COVID-19 使用无创通气的指南通常不一致。本系统评价旨在评估指南的质量和可用性，以及大流行早期无创通气的重要性。
截至 2020 年 6 月 23 日，检索了 PubMed、Web of Science 和 Cochrane Library 等数据库以及国际组织网站和灰色文献，还对手头合格文献的参考文献进行了检索。
共有 26 条指南符合纳入标准。根据评估研究和评价指南（AGREE II）工具，指南的方法学质量较低。在六个领域中，发展严谨性和编辑独立性的质量最低。鉴于缺乏随机临床试验证据以及不同地区之间的巨大差异，关于 COVID-19 早期阶段无创通气的建议引发了相当大的争议。
在未来的大流行中，提高指南的方法学质量应该是一个目标。此外，还需要更好设计的随机临床试验来解决无创通气影响方面的矛盾。
PROSPERO 注册号：CRD42020198410。
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