Risk factors for failure of noninvasive positive pressure ventilation in treatment of acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: a meta analysis_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

HAN Shanshan ¹ ,  WANG Jin ² , YUN Xiuli ³

1. School of Medicine, Yan 'an University, Yanan, Shaanxi 716000, P. R. China;
2. Department of Urology, Affiliated Hospital of Yan'an University, Yanan, Shaanxi 716000, P. R. China;
3. Department of Nursing, Affiliated Hospital of Yan'an University, Yanan, Shaanxi 716000, P. R. China;

Corresponding?author：

WANG Jin, Email: 270613275@qq.com

Keywords：

Noninvasive positive pressure ventilation; Chronic obstructive pulmonary disease; Respiratory failure; Risk factors; Meta-analysis

DOI：

10.7507/1671-6205.202105035

Video：

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Objective The risk factors of noninvasive positive pressure ventilation (NPPV) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with failure of respiratory failure were identified by meta-analysis, so as to provide a basis for early clinical prevention and treatment failure and early intervention. Methods PubMed, The Cochrane Library, EMbase, China National Knowledge Infrastructure, Wanfang, VIP and CBM Data were searched to collect studies about risk factors about failure of noninvasive positive pressure ventilation in AECOPD and respiratory failure published from January 2000 to January 2021. Two researchers independently conducted literature screening, literature data extraction and quality assessment. Meta-analysis was performed on the final literature obtained using RevMan 5.3 software. Results Totally 19 studies involving 3418 patients were recruited. The statistically significant risk factors included Acute Physiology and Chronic Health Evaluation (APACHEⅡ) score, pre-treatment PCO₂, pre-treatment pH, Glasgow Coma Scale (GCS), respiratory rate (RR) before treatment, body mass index (BMI), age, C-reactive protein (CRP), renal insufficiency, sputum disturbance, aspiration of vomit. Conclusions High APACHE-Ⅱ score, high PCO₂ before treatment, low pH value before treatment, low GCS score, high RR before treatment, low BMI, advanced age, low albumin, high CRP, renal insufficiency, sputum disturbance, and vomit aspiration were the risk factors for failure of respiratory failure in patients with COPD treated by NIPPV. Failure of non-invasive positive pressure ventilation in COPD patients with respiratory failure is affected by a variety of risk factors, and early identification and control of risk factors is particularly important to reduce the rate of treatment failure.

Citation： HAN Shanshan, WANG Jin, YUN Xiuli. Risk factors for failure of noninvasive positive pressure ventilation in treatment of acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: a meta analysis. Chinese Journal of Respiratory and Critical Care Medicine, 2021, 20(10): 694-702. doi: 10.7507/1671-6205.202105035 Copy

1.	Keenan SP, Sinuff T, Cook DJ, et al. 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(11): 861-870.
2.	Osadnik CR, Tee VS, Carson-Chahhoud KV, et al. Non-invasive ventilation for the management of acute hypercapnic respiratory failure due to exacerbation of chronic obstructive pulmonary disease. Cochrane Database Syst Rev, 2017, 7(7): CD004104.
3.	王建軍, 姜宏英, 李勍. 經鼻高流量濕化氧療與無創正壓通氣治療慢性阻塞性肺疾病急性加重伴Ⅱ型呼吸衰竭的隨機對照研究. 中國急救醫學, 2019, 39(10): 945-948.
4.	楊遠君. 右美托咪定在慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭患者無創正壓通氣(NPPV)中的治療作用分析. 吉林醫學, 2018, 39(10): 1894-1895.
5.	Shi JX, Xu J, Sun WK, et al. Effect of noninvasive, positive pressure ventilation on patients with severe, stable chronic obstructive pulmonary disease: a meta-analysis. Chin Med J (Engl), 2013, 126(1): 140-146.
6.	Fan L, Zhao Q, Liu Y, et al. Semiquantitative cough strength score and associated outcomes in noninvasive positive pressure ventilation patients with acute exacerbation of chronic obstructive pulmonary disease. Respir Med, 2014, 108(12): 1801-1807.
7.	Soliman MA, El-Shazly MI, Soliman YMA, et al. Effectiveness of non invasive positive pressure ventilation in chronic obstructive pulmonary disease patients. Egypt J Chest Dis Tuberc, 2014, 63(2): 309-312.
8.	張玉梅, 鄭亞安, 劉桂花. 無創性雙水平氣道正壓機械通氣治療在COPD合并急性呼吸衰竭的急診患者中的療效預測因素. 中國全科醫學, 2009, 12(1): 16-19.
9.	Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
10.	任凱峰. 影響無創正壓通氣治療慢性阻塞性肺疾病伴呼吸衰竭療效的因素探討. 實用預防醫學, 2009, 16(6): 1903-1904.
11.	徐麗娜, 曹潔, 陳寶元. AECOPD呼吸衰竭患者無創正壓通氣治療效果的相關因素分析. 國際呼吸雜志, 2010, 30(17): 1042-1044.
12.	郭偉, 張新日. 無創正壓通氣治療慢性阻塞性肺疾病急性加重合并呼吸衰竭失敗的相關因素分析. 山西醫科大學學報, 2012, 43(1): 38-41.
13.	馮濤. 無創正壓通氣治療老年慢性阻塞性肺病急性加重期合并呼吸衰竭失敗的相關因素. 中國老年學雜志, 2012, 32(22): 5031-5032.
14.	何煒, 揭志軍, 冷蓓崢, 等. COPD急性加重并呼吸衰竭患者無創正壓通氣治療失敗原因分析. 臨床誤診誤治, 2012, 25(8): 12-15.
15.	譚偉, 孫龍鳳, 代冰, 等. 慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭患者使用無創正壓通氣成功的臨床預測因素研究. 中國全科醫學, 2013, 16(2): 147-150.
16.	熊新發. 無創正壓機械通氣治療AECOPD并Ⅱ型呼吸衰竭的失敗原因分析. 臨床肺科雜志, 2014, (9): 1712-1714.
17.	何俊俏. 無創正壓通氣治療慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭失敗的相關因素研究. 現代實用醫學, 2016, 28(11): 1446-1448.
18.	王金榮, 邵立業, 郭偉, 等. 無創通氣治療肺性腦病研究進展. 國際呼吸雜志, 2018, 38(2): 156-160.
19.	葉靜凡, 劉家莉, 董飛, 等. 無創正壓通氣治療慢性阻塞性肺疾病急性加重并急性呼吸衰竭失敗的危險因素分析. 華西醫學, 2017, 32(11): 1702-1707.
20.	李文峰, 楊軻, 鄧興臣, 等. 無創通氣治療慢性阻塞性肺疾病急性發作合并Ⅱ型呼吸衰竭的療效及影響因素. 海南醫學, 2018, 29(13): 1787-1789.
21.	范小玉, 李秀. NPPV治療AECOPD合并重度呼吸性酸中毒失敗相關因素分析. 臨床肺科雜志, 2019, 24(5): 822-826.
22.	Cui J, Wan Q, Wu X, et al. Nutritional Risk Screening 2002 as a predictor of outcome during general ward-based noninvasive ventilation in chronic obstructive pulmonary disease with respiratory failure. Med Sci Monit, 2015, 21: 2786-2793.
23.	Aziz AOA, El-Bary IMA, Fattah MTA, et al. Effectiveness and safety of noninvasive positive-pressure ventilation in hypercapnia respiratory failure secondary to acute exacerbation of chronic obstructive pulmonary disease. Egypt J Bronchol, 2017, 11(3): 215-223.
24.	Chakrabarti B, Angus RM, Agarwal S, et al. Hyperglycaemia as a predictor of outcome during non-invasive ventilation in decompensated COPD. Thorax, 2009, 64(10): 857-862.
25.	Putinati S, Ballerin L, Piattella M, et al. Is it possible to predict the success of non-invasive positivepressure ventilation in acute respiratory failure due to COPD? Respir Med, 2000, 94(10): 997-1001.
26.	Confalonieri M, Garuti G, Cattaruzza MS, et al. Italian noninvasive positive pressure ventilation (NPPV) study group. A chart of failure risk for noninvasive ventilation in patients with COPD exacerbation. Eur Respir J, 2005, 25(2): 348-355.
27.	馮力. Bipap治療慢性阻塞性肺疾病伴中重度呼吸衰竭失敗的危險因素分析. 河北醫藥, 2014, (6): 876-877.
28.	Hallin R, Gudmundsson G, Suppli Ulrik C, et al. Nutritional status and long-term mortality in hospitalised patients with chronic obstructive pulmonary disease (COPD). Respir Med, 2007, 101(9): 1954-1960.
29.	Trayhurn P, Wood IS. Adipokines: inflammation and the pleiotropic role of white adipose tissue. Br J Nutr, 2004, 92(3): 347-355.
30.	杜崇軍. 無創正壓通氣治療慢性阻塞性肺病急性加重期伴呼吸衰竭失敗的相關因素分析. 第三軍醫大學學報, 2010, 32(12): 1362,1365.
31.	Plant PK, Owen JL, Elliott MW. Non-invasive ventilation in acute exacerbations of chronic obstructive pulmonary disease: long term survival and predictors of in-hospital outcome. Thorax, 2001, 56(9): 708-712.
32.	林肖琴, 張近波, 張麗紅, 等. 治療COPD所致呼吸衰竭以改良GCS評分≥13分作為有創–無創序貫通氣切換點的效果觀察. 浙江醫學, 2018, 40(16): 1823-1826.
33.	Pacilli AM, Valentini I, Carbonara P, et al. Determinants of noninvasive ventilation outcomes during an episode of acute hypercapnic respiratory failure in chronic obstructive pulmonary disease: the effects of comorbidities and causes of respiratory failure. Biomed Res Int, 2014, 2014: 976783.
34.	Hurst JR, Donaldson GC, Perera WR, et al. Use of plasma biomarkers at exacerbation of chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2006, 174(8): 867-874.
35.	Miniati M, Monti S, Bottai M, et al. Prognostic value of C-reactive protein in chronic obstructive pulmonary disease. Intern Emerg Med, 2011, 6(5): 423-430.
36.	?ileda? A, Kaya A, Er?en Diken ?, et al. The risk factors for late failure of non-invasive mechanical ventilation in acute hypercapnic respiratory failure. Tuberk Toraks, 2014, 62(3): 177-182.
37.	李堅, 張德厚, 孫麗萍, 等. 無創正壓通氣救治慢性阻塞性肺疾病呼吸衰竭后期失敗的相關因素分析. 中國呼吸與危重監護雜志, 2003, 2(2): 100-103.
38.	宋寧燕, 徐勁松, 夏國際, 等. AECOPD合并Ⅱ型呼吸衰竭無創正壓通氣治療早期失敗的預警因素分析. 臨床肺科雜志, 2011, 16(10): 1529-1531.
39.	翁燕娜, 韓云, 李芳. 急性呼吸衰竭無創正壓通氣治療早期失敗的預警因素分析. 廣東醫學, 2010, 31(9): 1127-1129.

1. Keenan SP, Sinuff T, Cook DJ, et al. 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(11): 861-870.
2. Osadnik CR, Tee VS, Carson-Chahhoud KV, et al. Non-invasive ventilation for the management of acute hypercapnic respiratory failure due to exacerbation of chronic obstructive pulmonary disease. Cochrane Database Syst Rev, 2017, 7(7): CD004104.
3. 王建軍, 姜宏英, 李勍. 經鼻高流量濕化氧療與無創正壓通氣治療慢性阻塞性肺疾病急性加重伴Ⅱ型呼吸衰竭的隨機對照研究. 中國急救醫學, 2019, 39(10): 945-948.
4. 楊遠君. 右美托咪定在慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭患者無創正壓通氣(NPPV)中的治療作用分析. 吉林醫學, 2018, 39(10): 1894-1895.
5. Shi JX, Xu J, Sun WK, et al. Effect of noninvasive, positive pressure ventilation on patients with severe, stable chronic obstructive pulmonary disease: a meta-analysis. Chin Med J (Engl), 2013, 126(1): 140-146.
6. Fan L, Zhao Q, Liu Y, et al. Semiquantitative cough strength score and associated outcomes in noninvasive positive pressure ventilation patients with acute exacerbation of chronic obstructive pulmonary disease. Respir Med, 2014, 108(12): 1801-1807.
7. Soliman MA, El-Shazly MI, Soliman YMA, et al. Effectiveness of non invasive positive pressure ventilation in chronic obstructive pulmonary disease patients. Egypt J Chest Dis Tuberc, 2014, 63(2): 309-312.
8. 張玉梅, 鄭亞安, 劉桂花. 無創性雙水平氣道正壓機械通氣治療在COPD合并急性呼吸衰竭的急診患者中的療效預測因素. 中國全科醫學, 2009, 12(1): 16-19.
9. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
10. 任凱峰. 影響無創正壓通氣治療慢性阻塞性肺疾病伴呼吸衰竭療效的因素探討. 實用預防醫學, 2009, 16(6): 1903-1904.
11. 徐麗娜, 曹潔, 陳寶元. AECOPD呼吸衰竭患者無創正壓通氣治療效果的相關因素分析. 國際呼吸雜志, 2010, 30(17): 1042-1044.
12. 郭偉, 張新日. 無創正壓通氣治療慢性阻塞性肺疾病急性加重合并呼吸衰竭失敗的相關因素分析. 山西醫科大學學報, 2012, 43(1): 38-41.
13. 馮濤. 無創正壓通氣治療老年慢性阻塞性肺病急性加重期合并呼吸衰竭失敗的相關因素. 中國老年學雜志, 2012, 32(22): 5031-5032.
14. 何煒, 揭志軍, 冷蓓崢, 等. COPD急性加重并呼吸衰竭患者無創正壓通氣治療失敗原因分析. 臨床誤診誤治, 2012, 25(8): 12-15.
15. 譚偉, 孫龍鳳, 代冰, 等. 慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭患者使用無創正壓通氣成功的臨床預測因素研究. 中國全科醫學, 2013, 16(2): 147-150.
16. 熊新發. 無創正壓機械通氣治療AECOPD并Ⅱ型呼吸衰竭的失敗原因分析. 臨床肺科雜志, 2014, (9): 1712-1714.
17. 何俊俏. 無創正壓通氣治療慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭失敗的相關因素研究. 現代實用醫學, 2016, 28(11): 1446-1448.
18. 王金榮, 邵立業, 郭偉, 等. 無創通氣治療肺性腦病研究進展. 國際呼吸雜志, 2018, 38(2): 156-160.
19. 葉靜凡, 劉家莉, 董飛, 等. 無創正壓通氣治療慢性阻塞性肺疾病急性加重并急性呼吸衰竭失敗的危險因素分析. 華西醫學, 2017, 32(11): 1702-1707.
20. 李文峰, 楊軻, 鄧興臣, 等. 無創通氣治療慢性阻塞性肺疾病急性發作合并Ⅱ型呼吸衰竭的療效及影響因素. 海南醫學, 2018, 29(13): 1787-1789.
21. 范小玉, 李秀. NPPV治療AECOPD合并重度呼吸性酸中毒失敗相關因素分析. 臨床肺科雜志, 2019, 24(5): 822-826.
22. Cui J, Wan Q, Wu X, et al. Nutritional Risk Screening 2002 as a predictor of outcome during general ward-based noninvasive ventilation in chronic obstructive pulmonary disease with respiratory failure. Med Sci Monit, 2015, 21: 2786-2793.
23. Aziz AOA, El-Bary IMA, Fattah MTA, et al. Effectiveness and safety of noninvasive positive-pressure ventilation in hypercapnia respiratory failure secondary to acute exacerbation of chronic obstructive pulmonary disease. Egypt J Bronchol, 2017, 11(3): 215-223.
24. Chakrabarti B, Angus RM, Agarwal S, et al. Hyperglycaemia as a predictor of outcome during non-invasive ventilation in decompensated COPD. Thorax, 2009, 64(10): 857-862.
25. Putinati S, Ballerin L, Piattella M, et al. Is it possible to predict the success of non-invasive positivepressure ventilation in acute respiratory failure due to COPD? Respir Med, 2000, 94(10): 997-1001.
26. Confalonieri M, Garuti G, Cattaruzza MS, et al. Italian noninvasive positive pressure ventilation (NPPV) study group. A chart of failure risk for noninvasive ventilation in patients with COPD exacerbation. Eur Respir J, 2005, 25(2): 348-355.
27. 馮力. Bipap治療慢性阻塞性肺疾病伴中重度呼吸衰竭失敗的危險因素分析. 河北醫藥, 2014, (6): 876-877.
28. Hallin R, Gudmundsson G, Suppli Ulrik C, et al. Nutritional status and long-term mortality in hospitalised patients with chronic obstructive pulmonary disease (COPD). Respir Med, 2007, 101(9): 1954-1960.
29. Trayhurn P, Wood IS. Adipokines: inflammation and the pleiotropic role of white adipose tissue. Br J Nutr, 2004, 92(3): 347-355.
30. 杜崇軍. 無創正壓通氣治療慢性阻塞性肺病急性加重期伴呼吸衰竭失敗的相關因素分析. 第三軍醫大學學報, 2010, 32(12): 1362,1365.
31. Plant PK, Owen JL, Elliott MW. Non-invasive ventilation in acute exacerbations of chronic obstructive pulmonary disease: long term survival and predictors of in-hospital outcome. Thorax, 2001, 56(9): 708-712.
32. 林肖琴, 張近波, 張麗紅, 等. 治療COPD所致呼吸衰竭以改良GCS評分≥13分作為有創–無創序貫通氣切換點的效果觀察. 浙江醫學, 2018, 40(16): 1823-1826.
33. Pacilli AM, Valentini I, Carbonara P, et al. Determinants of noninvasive ventilation outcomes during an episode of acute hypercapnic respiratory failure in chronic obstructive pulmonary disease: the effects of comorbidities and causes of respiratory failure. Biomed Res Int, 2014, 2014: 976783.
34. Hurst JR, Donaldson GC, Perera WR, et al. Use of plasma biomarkers at exacerbation of chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2006, 174(8): 867-874.
35. Miniati M, Monti S, Bottai M, et al. Prognostic value of C-reactive protein in chronic obstructive pulmonary disease. Intern Emerg Med, 2011, 6(5): 423-430.
36. ?ileda? A, Kaya A, Er?en Diken ?, et al. The risk factors for late failure of non-invasive mechanical ventilation in acute hypercapnic respiratory failure. Tuberk Toraks, 2014, 62(3): 177-182.
37. 李堅, 張德厚, 孫麗萍, 等. 無創正壓通氣救治慢性阻塞性肺疾病呼吸衰竭后期失敗的相關因素分析. 中國呼吸與危重監護雜志, 2003, 2(2): 100-103.
38. 宋寧燕, 徐勁松, 夏國際, 等. AECOPD合并Ⅱ型呼吸衰竭無創正壓通氣治療早期失敗的預警因素分析. 臨床肺科雜志, 2011, 16(10): 1529-1531.
39. 翁燕娜, 韓云, 李芳. 急性呼吸衰竭無創正壓通氣治療早期失敗的預警因素分析. 廣東醫學, 2010, 31(9): 1127-1129.

Chinese Journal of Respiratory and Critical Care Medicine

Risk factors for failure of noninvasive positive pressure ventilation in treatment of acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: a meta analysis

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