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Clinical efficacy of helmet and face mask noninvasive ventilation on patients with respiratory failure: a Meta-analysis
- HONG Shukun, TIAN Yonggang, LI Yahong, QIAO Lujun
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Journal of Shandong University (Health Sciences). 2019, 57(7):
92-101.
doi:10.6040/j.issn.1671-7554.0.2018.1274
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Objective To evaluate the clinical efficacy of helmet and face mask noninvasive ventilation on patients with respiratory failure. Methods By searching literature database including Medline(Pubmed), Cochrane Library, Web of Science, Wanfang, CNKI and Chinese Biological Medicine Database, randomized controlled trials comparing helmet and face mask noninvasive ventilation, which were defined as helmet group and face mask group, for patients with respiratory failure were selected according to inclusion and exclusion criteria. Data were extracted and quality assessment was conducted by using “risk of bias” criteria specified by the Cochrane Collaboration and Jadad scoring system. Meta-analysis was performed by using statistical software of Review manager 5.1.0. Results Overall, ten randomized controlled trials were included, with 228 cases in helmet group and 223 cases in face mask group. The Meta-analysis showed that, compared with face mask, helmet could significantly decrease the incidences of intolerance(RR=0.18,95%CI: 0.08-0.41,P<0.001), skin ulcer(RR=0.19,95%CI: 0.08-0.48,P<0.001)and gastric distension(RR=0.15,95%CI: 0.05-0.42,P<0.001), reduce the respiratory rate (MD=-3.01,95%CI: -4.87 - 1.16,P=0.001), endotracheal intubation rate(RR=0.39,95%CI: 0.26-0.59,P<0.001)and mortality(RR=0.59,95%CI: 0.36-0.96,P=0.030), and increase the oxygenation index of type-I respiratory failure(MD=60.45,95%CI: 20.44-100.46, P=0.003). How- 山 东 大 学 学 报 (医 学 版)57卷7期 -洪树坤,等.头罩与面罩无创通气对呼吸衰竭患者临床疗效的Meta分析 \=-ever, the ability of reducing PaCO2 of type-II respiratory failure of helmet was less than that of face mask(MD=5.86,95%CI: 3.64-8.08,P<0.001). Conclusion Compared with face mask, helmet can improve the patients’ tolerance, reduce the adverse events, increase the oxygenation effect, and decrease the risk of endotracheal intubation. Helmet has no advantage over face mask in eliminating the retention of CO2.