Anesthesia and Critical Care Department, Saint Eloi Teaching Hospital, University of Montpellier 1, 80 Avenue Augustin Fliche, 34295, Montpellier Cedex 5, France.
Anesthesiology and Intensive Care Department, University of La Guadeloupe, 97159, Pointe A Pitre, Guadeloupe.
Intensive Care Med. 2022 Nov;48(11):1513-1524. doi: 10.1007/s00134-022-06821-y. Epub 2022 Sep 16.
The aim of this study was to perform a systematic review and meta-analysis to investigate the incidence rate of cardiac arrest and severe complications occurring under non-invasive ventilation (NIV).
We performed a systematic review and meta-analysis of studies between 1981 and 2020 that enrolled adults in whom NIV was used to treat acute respiratory failure (ARF). We generated the pooled incidence and confidence interval (95% CI) of NIV-related cardiac arrest per patient (primary outcome) and performed a meta-regression to assess the association with study characteristics. We also generated the pooled incidences of NIV failure and hospital mortality.
Three hundred and eight studies included a total of 7,601,148 participants with 36,326 patients under NIV (8187 in 138 randomized controlled trials, 9783 in 99 prospective observational studies, and 18,356 in 71 retrospective studies). Only 19 (6%) of the analyzed studies reported the rate of NIV-related cardiac arrest. Forty-nine cardiac arrests were reported. The pooled incidence was 0.01% (95% CI 0.00-0.02, I = 0% (0-15)). NIV failure was reported in 4371 patients, with a pooled incidence of 11.1% (95% CI 9.0-13.3). After meta-regression, NIV failure and the study period (before 2010) were significantly associated with NIV-related cardiac arrest. The hospital mortality pooled incidence was 6.0% (95% CI 4.4-7.9).
Cardiac arrest related to NIV occurred in one per 10,000 patients under NIV for ARF treatment. NIV-related cardiac arrest was associated with NIV failure.
本研究旨在进行系统评价和荟萃分析，以调查非侵入性通气（NIV）下发生心脏骤停和严重并发症的发生率。
我们对 1981 年至 2020 年期间纳入接受 NIV 治疗急性呼吸衰竭（ARF）的成年患者的研究进行了系统评价和荟萃分析。我们生成了每例患者与 NIV 相关的心脏骤停的汇总发生率和置信区间（95%CI）（主要结局），并进行了荟萃回归分析以评估与研究特征的关联。我们还生成了 NIV 失败和医院死亡率的汇总发生率。
308 项研究共纳入了 7601148 名参与者，其中 36326 名患者接受了 NIV（138 项随机对照试验中有 8187 名，99 项前瞻性观察性研究中有 9783 名，71 项回顾性研究中有 18356 名）。只有 19%（6%）的分析研究报告了与 NIV 相关的心脏骤停率。报告了 49 例心脏骤停。汇总发生率为 0.01%（95%CI 0.00-0.02，I=0%（0-15））。报告了 4371 例 NIV 失败，汇总发生率为 11.1%（95%CI 9.0-13.3）。荟萃回归后，NIV 失败和研究期间（2010 年前）与与 NIV 相关的心脏骤停显著相关。医院死亡率的汇总发生率为 6.0%（95%CI 4.4-7.9）。
NIV 治疗 ARF 时，每 10000 名患者中就有 1 例发生与 NIV 相关的心脏骤停。与 NIV 相关的心脏骤停与 NIV 失败有关。
