The following is a summary of “Effects of non-invasive respiratory support in post-operative patients: a systematic review and network meta-analysis,” published in the May 2024 issue of Critical Care by Pettenuzzo et al.
To prevent complications after surgery, researchers are exploring non-invasive respiratory support (NRS) methods like high-flow nasal oxygen and non-invasive ventilation (NIV) instead of conventional oxygen therapy (COT).
Researchers conducted a retrospective study assessing the impact of NRS compared to COT on re-intubation rates (primary outcome) and other secondary outcomes in adult surgery patients after extubation.
They conducted a systematic review and network meta-analysis (SRNMA), including RCTs and non-RCTs. The search encompassed databases like Medline, Embase, Scopus, Cochrane Central Register of Controlled Trials, and Web of Science (February 2, 2024).
The results showed that in 33 studies involving 11,292 patients, NIV was the only NRS modality that decreased re-intubation rates compared to COT. This effect was particularly notable in patients treated with NIV for post-extubation respiratory failure, especially those at high risk. Additionally, NIV reduced rates of nosocomial pneumonia, length of stay in the ICU, and ICU, hospital, and long-term mortality without exacerbating patient discomfort (P=0.015, OR 0.49, 95% CI 0.28; 0.87, I2 = 60.5%, low certainty of evidence).
Investigators found that NIV use in high-risk post-surgical patients receiving NRS post-extubation reduced re-intubation rates compared to COT.
Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-04924-0
