Tuberc Respir Dis > Accepted Articles
DOI: https://doi.org/10.4046/trd.2021.0062    [Accepted]
Published online November 15, 2021.
The long-term efficacy of domiciliary noninvasive positive pressure ventilation in COPD: A meta-analysis of randomized controlled trials
So Young Park1, Kwang Ha Yoo2, Yong Bum Park3, Chin Kook Rhee4, Jinkyeong Park5, Hye Yun Park6, Yong Il Hwang7, Dong Ah Park8, Yun Su Sim9
1Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
2Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea
3Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kandong Sacred Heart Hospital, Seoul, Republic of Korea
4Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary’s Hospital, Catholic University of Korea, Seoul, Korea
5Division of Pulmonary, Department of Internal Medicine, Dongguk University College of Medicine, Seoul, Republic of Korea
6Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
7Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
8Division of Healthcare Technology Assessment Research, Office of Health Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Republic of Korea
9Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
Correspondence:  Yun Su Sim, Tel: +82-2-829-5118, Fax: +82-2-846-4669, 
Email: sysliver@naver.com
Received: 8 June 2021   • Revised: 17 September 2021   • Accepted: 7 November 2021
Abstract
We aimed to evaluate the long-term use or effects of domiciliary non-invasive positive pressure ventilation (NIPPV) used to treat patients with chronic obstructive pulmonary disease (COPD). Databases were searched to identify randomized controlled trials (RCTs) of COPD with NIPPV for longer than 1 year. The primary outcome as mortality rates were accessed in this meta-analysis. The eight trials included in this study comprised data from 913 patients. The mortality rates for the NIPPV and control groups were 29% (118/414) and 36% (151/419); this difference was statistically significant (risk ratio (RR): 0.79, 95% confidence interval (CI): 0.65–0.95). Mortality rates were reduced with NIPPV in four trials that included stable COPD patients. There was no difference in admission, acute exacerbation and quality of life (QOL) between the NIPPV and control groups. There was no significant difference in withdrawal rates between the two groups (RR 0.99, 95% CI 0.72-1.36, p = 0.94). Maintaining long-term nocturnal NIPPV for more than 1 year in COPD patients, especially stable status COPD patients, leads to a decrease in the mortality rate, and the withdrawal rate is not high compared to long term oxygen treatments.
Key Words: noninvasive positive-pressure ventilation, chronic obstructive pulmonary disease, mortality


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