Suleman Aimen, Sohailuddin Mohammad, Sta Ines Mars Christian Aragon, Fattani Bilal, Mustafa Meladi Ghulam, Ullah Khan Zahid, Ullah Sana, Khalid Aneesa, Zara Komal
Medical Diagnostics, GCC Diagnostic Center, Islamabad, PAK.
Department of Accident and Emergency, Maidstone and Turnbridge Wells Hospital, Maidstone, GBR.
Cureus. 2025 May 7;17(5):e83624. doi: 10.7759/cureus.83624. eCollection 2025 May.
Non-invasive ventilation (NIV) has gained attention as an important intervention for the treatment of acute respiratory failure (ARF) in both resource-constrained and non-intensive care unit (ICU) settings. Clinical outcomes and the efficacy and failure indicators of NIV treatment are still inconsistent across a wide range of research studies. This systematic review and meta-analysis evaluated the efficacy of NIV in ARF by looking at treatment site effects, failure predictor variables, together with aggregated outcomes. Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines, this study looked for pertinent research studies from 2000 to 2025 by employing PubMed, Scopus, Embase, and Cochrane Library databases. Adult patients who met the inclusion criteria received NIV treatment for ARF. The random-effects method calculated odds ratio pools (ORs) for outcome achievement and non-achievement across the studies. Standardized instruments that relied on the features of the study design were used to assess the risk of bias. Eleven studies (n=20,312) were included. The pooled OR for improved outcomes with NIV was 2.01 (95% CI: 1.66-2.43). Success rates ranged from 55.6% to 72.1% with common failure predictors including elevated respiratory rate, CO₂ levels, D-dimer as well as clinical indices such as respiratory rate-oxygenation (ROX) and heart rate, acidosis, consciousness, oxygenation, and respiratory rate (HACOR) scores. NIV was effective in both ICU and general ward settings. NIV significantly improved the outcomes in ARF that offered a viable strategy in various settings. Early identification of respiratory failure by using the validated clinical tools was essential. These findings supported broader application of NIV in clinical practice.
无创通气（NIV）作为治疗急性呼吸衰竭（ARF）的一种重要干预措施，在资源有限的环境和非重症监护病房（ICU）中均受到关注。在众多研究中，NIV治疗的临床结果以及疗效和失败指标仍不一致。本系统评价和荟萃分析通过观察治疗部位效应、失败预测变量以及综合结果，评估了NIV在ARF中的疗效。遵循《系统评价和荟萃分析的首选报告项目》（PRISMA）2020指南，本研究通过使用PubMed、Scopus、Embase和Cochrane图书馆数据库，查找2000年至2025年的相关研究。符合纳入标准的成年患者接受了NIV治疗ARF。随机效应方法计算了各研究中结局达成和未达成的比值比汇总值（OR）。依靠研究设计特征的标准化工具用于评估偏倚风险。纳入了11项研究（n = 20,312）。NIV改善结局的合并OR为2.01（95%CI：1.66 - 2.43）。成功率在55.6%至72.1%之间，常见的失败预测因素包括呼吸频率升高、二氧化碳水平、D - 二聚体以及呼吸频率 - 氧合（ROX）和心率、酸中毒、意识、氧合和呼吸频率（HACOR）评分等临床指标。NIV在ICU和普通病房环境中均有效。NIV显著改善了ARF的结局，在各种环境中提供了一种可行的策略。使用经过验证的临床工具早期识别呼吸衰竭至关重要。这些发现支持了NIV在临床实践中的更广泛应用。
