Noninvasive Ventilation in Exacerbations of Chronic Obstructive Pulmonary Disease: Implications of Different Meta-Analytic Strategies

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Letters7 September 2004Noninvasive Ventilation in Exacerbations of Chronic Obstructive Pulmonary Disease: Implications of Different Meta-Analytic StrategiesJohn V. Peter, MD and John L. Moran, MBBS, FRACP, FANZCAJohn V. Peter, MDFrom Lyell McEwin Health Centre, Elizabeth, South Australia 5112; and The Queen Elizabeth Hospital, Woodville, South Australia 5011. and John L. Moran, MBBS, FRACP, FANZCAFrom Lyell McEwin Health Centre, Elizabeth, South Australia 5112; and The Queen Elizabeth Hospital, Woodville, South Australia 5011.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-5-200409070-00031-w1 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Recent meta-analyses (1-3) have examined the role of noninvasive ventilation in acute exacerbations of chronic obstructive pulmonary disease (COPD).Objective: To assess the use of different analytic strategies in interpreting the results of these meta-analyses.Methods and Findings: Two issues are important in considering evidence for use of noninvasive ventilation in acute exacerbations of COPD. First, what constitutes an “acute exacerbation”? Exacerbation of COPD is defined (4) as “a sustained worsening of the patient's condition, from the stable state and beyond normal day-to-day variations, that is acute in onset and necessitates change in regular medication in ...References1. Keenan SP, Sinuff T, Cook DJ, Hill NS. Which patients with acute exacerbation of chronic obstructive pulmonary disease benefit from noninvasive positive-pressure ventilation? A systematic review of the literature. Ann Intern Med. 2003;138:861-70. [PMID: 12779296] LinkGoogle Scholar2. Peter JV, Moran JL, Phillips-Hughes J, Warn D. Noninvasive ventilation in acute respiratory failure—a meta-analysis update. Crit Care Med. 2002;30:555-62. [PMID: 11990914] CrossrefMedlineGoogle Scholar3. Lightowler JV, Wedzicha JA, Elliott MW, Ram FS. Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis. BMJ. 2003;326:185. [PMID: 12543832] CrossrefMedlineGoogle Scholar4. Rodriguez-Roisin R. Toward a consensus definition for COPD exacerbations. Chest. 2000;117:398S-401S. [PMID: 10843984] CrossrefMedlineGoogle Scholar5. Confalonieri M, Potena A, Carbone G, Porta RD, Tolley EA, Umberto Meduri G. Acute respiratory failure in patients with severe community-acquired pneumonia. A prospective randomized evaluation of noninvasive ventilation. Am J Respir Crit Care Med. 1999;160:1585-91. [PMID: 10556125] CrossrefMedlineGoogle Scholar6. Celikel T, Sungur M, Ceyhan B, Karakurt S. Comparison of noninvasive positive pressure ventilation with standard medical therapy in hypercapnic acute respiratory failure. Chest. 1998;114:1636-42. [PMID: 9872200] CrossrefMedlineGoogle Scholar7. Martin TJ, Hovis JD, Costantino JP, Bierman MI, Donahoe MP, Rogers RM, et al . A randomized, prospective evaluation of noninvasive ventilation for acute respiratory failure. Am J Respir Crit Care Med. 2000;161:807-13. [PMID: 10712326] CrossrefMedlineGoogle Scholar8. Plant PK, Owen JL, Elliott MW. Early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease on general respiratory wards: a multicentre randomised controlled trial. Lancet. 2000;355:1931-5. [PMID: 10859037] CrossrefMedlineGoogle Scholar9. Bott J, Carroll MP, Conway JH, Keilty SE, Ward EM, Brown AM, et al . Randomised controlled trial of nasal ventilation in acute ventilatory failure due to chronic obstructive airways disease. Lancet. 1993;341:1555-7. [PMID: 8099639] CrossrefMedlineGoogle Scholar10. Avdeev SN, Tret'iakov AV, Grigor'iants RA, Kutsenko MA, Chuchalin AG. [Study of the use of noninvasive ventilation of the lungs in acute respiratory insufficiency due exacerbation of chronic obstructive pulmonary disease]. Anesteziol Reanimatol. 1998;:45-51. [PMID: 9693434] MedlineGoogle Scholar11. Keenan SP, Powers C, McCormack DG. Noninvasive ventilation in milder COPD exacerbations: an RCT [Abstract]. Am J Resp Crit Care. 2001;163:A250. Google Scholar12. Dikensoy O, Ikidag B, Filiz A, Bayram N. Comparison of non-invasive ventilation and standard medical therapy in acute hypercapnic respiratory failure: a randomised controlled study at a tertiary health centre in SE Turkey. Int J Clin Pract. 2002;56:85-8. [PMID: 11926711] MedlineGoogle Scholar13. Barbe F, Togores B, Rubi M, Pons S, Maimo A, Agusti AG. Noninvasive ventilatory support does not facilitate recovery from acute respiratory failure in chronic obstructive pulmonary disease. Eur Respir J. 1996;9:1240-5. [PMID: 8804944] CrossrefMedlineGoogle Scholar14. Brochard L, Mancebo J, Wysocki M, Lofaso F, Conti G, Rauss A, et al . Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N Engl J Med. 1995;333:817-22. [PMID: 7651472] CrossrefMedlineGoogle Scholar15. Daskalopoulou E, Tsara V, Fekete K, Koutsantas V, Christaki P. Treatment of acute respiratory failure in COPD patients with positive pressure via nasal mask [Abstract]. Chest. 1993;103:271S. MedlineGoogle Scholar16. Servillo G, Ughi L, Rossano F, Leone D. Noninvasive mask pressure support ventilation in COPD patients [Abstract]. Intensive Care Med. 1994;50:S54. Google Scholar17. Khilnani GC, Saikia N, Sharma SK, Pande JN, Malhotra OP. Efficacy of non-invasive pressure ventilation for the management of COPD with acute or acute on chronic respiratory failure: a randomized, controlled trial [Abstract]. Am J Respir Crit Care Med. 2002;165:A387. MedlineGoogle Scholar18. MacNee W. Acute exacerbations of COPD. Swiss Med Wkly. 2003;133:247-57. [PMID: 12833195] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Lyell McEwin Health Centre, Elizabeth, South Australia 5112; and The Queen Elizabeth Hospital, Woodville, South Australia 5011. 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