Effects of different oxygen therapies on conservative treatment of spontaneous pneumothorax: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CAO Xiong ^1,2 , LI Xiuxia ^3,4,5 , LIN Ruijiang ² ,  YANG Kehu ^4,5 ,  HAN Biao ²

1. First Clinical Medical College, Lanzhou University, Lanzhou, 730000, P.R.China;
2. First Hospital, Lanzhou University, Lanzhou, 730000, P.R.China;
3. School of Public Health, Lanzhou University, Lanzhou, 730000, P.R.China;
4. Evidence-based Medicine Center, Lanzhou University/School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, P.R.China;
5. The Key Laboratory of Evidence-based Medicine and Clinical Transformation, Gansu Province, Lanzhou, 730000, P.R.China;

Corresponding?author：

YANG Kehu, Email: kehuyangebm2006@126.com; HAN Biao, Email: hanbiao66@163.com

Keywords：

Spontaneous pneumothorax; oxygen therapy; meta-analysis; randomized controlled trial

DOI：

10.7507/1007-4848.201804050

Video：

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Objective To investigate the effects of two different oxygen therapies (oxygen time<4 h/d, oxygen flow>6 L/min versus oxygen time>4 h/d, oxygen flow<6 L/min) on conservative treatment of spontaneous pneumothorax by meta-analysis.Methods The following electronic databases as PubMed, The Cochrane Library, Web of Science, Chinese Biomedical Literature Database, WanFang Database and China National Knowledge Database were retrieved on computer for randomized controlled trials (RCTs) of comparing two different oxygen therapies (oxygen time<4 h/d, oxygen flow>6 L/min versus oxygen time>4 h/d, oxygen flow<6 L/min) on conservative treatment of spontaneous pneumothorax. The retrieval time was from inception of each database to December 2017. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then data were analyzed by RevMan 5.3 software.Results A total of 4 RCTs involving 226 patients were included. The meta-analysis showed that compared with lower oxygen flow (oxygen time>4 h/d, oxygen flow<6 L/min), the higher oxygen flow (oxygen time<4 h/d, oxygen flow>6 L/min) could obviously decrease the degree of pulmonary compression after oxygen therapy for 5 days (MD=–2.81, 95%CI –4.18 to –1.44, P<0.05), shorten duration of hospital stay (MD=–3.26, 95%CI –6.05 to –0.47, P<0.05) and duration of recruitment maneuvers (MD=–2.78, 95%CI –5.27 to –0.28, P<0.05), but there was no significant difference in oxygen partial pressure after oxygen therapy for 5 days (MD=10.68, 95%CI –7.03 to 28.39, P=0.24).Conclusion The higher oxygen flow (oxygen time<4 h/d, oxygen flow>6 L/min) can obviously decrease the degree of pulmonary compression after oxygen therapy for 5 days, shorten duration of hospital stay and duration of recruitment maneuvers, but the results are influenced by the number and quality of RCT.

Citation： CAO Xiong, LI Xiuxia, LIN Ruijiang, YANG Kehu, HAN Biao. Effects of different oxygen therapies on conservative treatment of spontaneous pneumothorax: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(3): 245-250. doi: 10.7507/1007-4848.201804050 Copy

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17.	彭員秀, 劉華敏. 不同氧流量治療慢性阻塞性肺疾病合并氣胸的臨床觀察. 護理實踐與研究, 2013, 10(4): 56-57.
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20.	唐琴琴, 徐丁, 田金徽, 等. 早產兒經鼻高流量氧療安全性和有效性的系統評價和 Meta 分析. 中國循證兒科雜志, 2017, 10(3): 175-179.
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1. 白明, 主譯. 現代肺部疾病診斷與治療. 北京: 人民衛生出版社, 2006: 189.
2. MacDuff A, Arnold A, Harvey J. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax, 2010, 65(Suppl 2): ii18-ii31.
3. Sahn SA, Heffner JE. Spontaneous pneumothorax. N Engl J Med, 2000, 342(12): 868-874.
4. Lichter J, Gwynne JF. Spontaneous pneumothorax in young subjects. Thorax, 1971, 25(3): 409-417.
5. Light RW. Management of spontaneous pneumothorax. Am Rev Respir Dis, 1993, 148(1): 245-258.
6. Baumann MH, Strange C, Heffner JE, et al. Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest, 2001, 119(2): 590-602.
7. Seremetis MG. The management of spontaneous pneumothorax. Chest, 1970, 57(1): 65-68.
8. Gobbel WG Jr, Rhea WG Jr. Spontaneous pneumothorax. J Thorac Cardiovasc Surg, 1963, 46(3): 331-345.
9. Voge VM, Anthracite R. Spontaneous pneumothorax in the USAF aircrew population: a retrospective study. Aviat Space Environ Med, 1986, 57(10 Pt 1): 939-949.
10. Tschopp JM, Rami-Porta R, Noppen M, et al. Management of spontaneous pneumothorax: state of the art. Eur Respir J, 2006, 28(3): 637-650.
11. Kelly A. Treatment of primary spontaneous pneumothorax. Curr Opin Pulm Med, 2009, 15(4): 376-379.
12. 陳灝珠, 主編. 實用內科學. 第 12 版. 北京: 人民衛生出版社, 2005.
13. 董敬軍, 陳建榮, 陳金亮, 等. 不同吸氧方法治療自發性氣胸效果比較. 實用醫院臨床雜志, 2010, 7(5): 74-76.
14. 陳央, 梁宗安, 陳軍. 高濃度吸氧及胸穿抽氣治療大學生特發性穩定型小量氣胸. 西部醫學, 2017, 29(4): 484-488.
15. Julian PT Higgins. Sally Green. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). Available at: http://handbook.cochrane.org/.
16. 鮑鳳. 氧療在自發性氣胸患者中的應用與護理. 安徽醫藥, 2012, 16(6): 863-864.
17. 彭員秀, 劉華敏. 不同氧流量治療慢性阻塞性肺疾病合并氣胸的臨床觀察. 護理實踐與研究, 2013, 10(4): 56-57.
18. 胡文滕, 藺瑞江, 滕元軍等. 中國循證醫學雜志, 2014, 14(8): 927-933.
19. 姚偉, 錢桂生. 胸膜疾病診斷治療新觀點(氣胸的處理). 中國實用內科雜志, 2008, 2(2): 81-83.
20. 唐琴琴, 徐丁, 田金徽, 等. 早產兒經鼻高流量氧療安全性和有效性的系統評價和 Meta 分析. 中國循證兒科雜志, 2017, 10(3): 175-179.
21. Henry M, Arnold T, Harvey J, et al. BTS guidelines for the management of spontaneous pneumothorax. Thorax, 2003, 58(Suppl II): ii39-ji52.
22. Dharmeshkumar N, Ashish G, Agarwal S, et al. Oxygen toxicity. JI- ACM, 2003, 4(3): 234-237.
23. 肖獻忠, 主編. 病理生理學. 第 3 版. 高等教育出版社, 2013. 80.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Effects of different oxygen therapies on conservative treatment of spontaneous pneumothorax: A systematic review and meta-analysis

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