Noninvasive ventilation as a weaning strategy for mechanical ventilation in adults with respiratory failure: a Cochrane systematic review

Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure

“…BURNS et al [127] identified 16 RCTs enrolling a total of 994 participants, mostly with COPD. Of the 16 studies, nine included only patients with COPD [128][129][130][131][132][133][134][135][136], six included mixed populations ( predominantly hypercapnic) [137][138][139][140][141][142] and one small pilot study included only hypoxaemic patients [143].…”

Variation in Definition of Prolonged Mechanical Ventilation

“…The role of non-invasive ventilation is an important element for consideration for this definition 24 , particularly in view of increased utilization in recent years 26 . A Cochrane systematic review found use of non-invasive ventilation as a weaning strategy to enable extubation for patients with the potential to wean, but not yet able to tolerate mechanical ventilation discontinuation, demonstrated decreased weaning failure, mortality, ventilator associated pneumonia, ventilation duration, and ICU length of stay compared to weaning strategies that did not include non-invasive ventilation 27 . Failure to consider the use of non-invasive ventilation after extubation when pooling data from studies that do or do not use an early extubation to noninvasive ventilation approach will produce inaccurate estimates of weaning success.…”

Noninvasive Ventilation Intolerance: Characteristics, Predictors, and Outcomes

“…[1][2][3][4] However, some patients fail to see an improvement in their acute respiratory failure because of NIV failure, and are intubated. Previous studies have reported that NIV intolerance is one of the causes for intubation, [5][6][7][8][9][10][11] and one of the studies 8 has shown that poor NIV tolerance is associated with higher intubation rates.…”