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.	王建军, 姜宏英, 李勍. 经鼻高流量湿化氧疗与无创正压通气治疗慢性阻塞性肺疾病急性加重伴Ⅱ型呼吸衰竭的随机对照研究. 中国急救医学, 2019, 39(10): 945-948.
4.	杨远君. 右美托咪定在慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭患者无创正压通气(NPPV)中的治疗作用分析. 吉林医学, 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.	张玉梅, 郑亚安, 刘桂花. 无创性双水平气道正压机械通气治疗在COPD合并急性呼吸衰竭的急诊患者中的疗效预测因素. 中国全科医学, 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.	任凯峰. 影响无创正压通气治疗慢性阻塞性肺疾病伴呼吸衰竭疗效的因素探讨. 实用预防医学, 2009, 16(6): 1903-1904.
11.	徐丽娜, 曹洁, 陈宝元. AECOPD呼吸衰竭患者无创正压通气治疗效果的相关因素分析. 国际呼吸杂志, 2010, 30(17): 1042-1044.
12.	郭伟, 张新日. 无创正压通气治疗慢性阻塞性肺疾病急性加重合并呼吸衰竭失败的相关因素分析. 山西医科大学学报, 2012, 43(1): 38-41.
13.	冯涛. 无创正压通气治疗老年慢性阻塞性肺病急性加重期合并呼吸衰竭失败的相关因素. 中国老年学杂志, 2012, 32(22): 5031-5032.
14.	何炜, 揭志军, 冷蓓峥, 等. COPD急性加重并呼吸衰竭患者无创正压通气治疗失败原因分析. 临床误诊误治, 2012, 25(8): 12-15.
15.	谭伟, 孙龙凤, 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无创正压通气成功的临床预测因素研究. 中国全科医学, 2013, 16(2): 147-150.
16.	熊新发. 无创正压机械通气治疗AECOPD并Ⅱ型呼吸衰竭的失败原因分析. 临床肺科杂志, 2014, (9): 1712-1714.
17.	何俊俏. 无创正压通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭失败的相关因素研究. 现代实用医学, 2016, 28(11): 1446-1448.
18.	王金荣, 邵立业, 郭伟, 等. 无创通气治疗肺性脑病研究进展. 国际呼吸杂志, 2018, 38(2): 156-160.
19.	叶静凡, 刘家莉, 董飞, 等. 无创正压通气治疗慢性阻塞性肺疾病急性加重并急性呼吸衰竭失败的危险因素分析. 华西医学, 2017, 32(11): 1702-1707.
20.	李文峰, 杨轲, 邓兴臣, 等. 无创通气治疗慢性阻塞性肺疾病急性发作合并Ⅱ型呼吸衰竭的疗效及影响因素. 海南医学, 2018, 29(13): 1787-1789.
21.	范小玉, 李秀. NPPV治疗AECOPD合并重度呼吸性酸中毒失败相关因素分析. 临床肺科杂志, 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.	冯力. Bipap治疗慢性阻塞性肺疾病伴中重度呼吸衰竭失败的危险因素分析. 河北医药, 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.	杜崇军. 无创正压通气治疗慢性阻塞性肺病急性加重期伴呼吸衰竭失败的相关因素分析. 第三军医大学学报, 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, 张近波, 张丽红, 等. 治疗COPD所致呼吸衰竭以改良GCS评分≥13分作为有创–无创序贯通气切换点的效果观察. 浙江医学, 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.	Çiledağ A, Kaya A, Erçen Diken Ö, 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.	李坚, 张德厚, 孙丽萍, 等. 无创正压通气救治慢性阻塞性肺疾病呼吸衰竭后期失败的相关因素分析. 中国呼吸与危重监护杂志, 2003, 2(2): 100-103.
38.	宋宁燕, 徐劲松, 夏国际, 等. AECOPD合并Ⅱ型呼吸衰竭无创正压通气治疗早期失败的预警因素分析. 临床肺科杂志, 2011, 16(10): 1529-1531.
39.	翁燕娜, 韩云, 李芳. 急性呼吸衰竭无创正压通气治疗早期失败的预警因素分析. 广东医学, 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. 王建军, 姜宏英, 李勍. 经鼻高流量湿化氧疗与无创正压通气治疗慢性阻塞性肺疾病急性加重伴Ⅱ型呼吸衰竭的随机对照研究. 中国急救医学, 2019, 39(10): 945-948.
4. 杨远君. 右美托咪定在慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭患者无创正压通气(NPPV)中的治疗作用分析. 吉林医学, 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. 张玉梅, 郑亚安, 刘桂花. 无创性双水平气道正压机械通气治疗在COPD合并急性呼吸衰竭的急诊患者中的疗效预测因素. 中国全科医学, 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. 任凯峰. 影响无创正压通气治疗慢性阻塞性肺疾病伴呼吸衰竭疗效的因素探讨. 实用预防医学, 2009, 16(6): 1903-1904.
11. 徐丽娜, 曹洁, 陈宝元. AECOPD呼吸衰竭患者无创正压通气治疗效果的相关因素分析. 国际呼吸杂志, 2010, 30(17): 1042-1044.
12. 郭伟, 张新日. 无创正压通气治疗慢性阻塞性肺疾病急性加重合并呼吸衰竭失败的相关因素分析. 山西医科大学学报, 2012, 43(1): 38-41.
13. 冯涛. 无创正压通气治疗老年慢性阻塞性肺病急性加重期合并呼吸衰竭失败的相关因素. 中国老年学杂志, 2012, 32(22): 5031-5032.
14. 何炜, 揭志军, 冷蓓峥, 等. COPD急性加重并呼吸衰竭患者无创正压通气治疗失败原因分析. 临床误诊误治, 2012, 25(8): 12-15.
15. 谭伟, 孙龙凤, 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无创正压通气成功的临床预测因素研究. 中国全科医学, 2013, 16(2): 147-150.
16. 熊新发. 无创正压机械通气治疗AECOPD并Ⅱ型呼吸衰竭的失败原因分析. 临床肺科杂志, 2014, (9): 1712-1714.
17. 何俊俏. 无创正压通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭失败的相关因素研究. 现代实用医学, 2016, 28(11): 1446-1448.
18. 王金荣, 邵立业, 郭伟, 等. 无创通气治疗肺性脑病研究进展. 国际呼吸杂志, 2018, 38(2): 156-160.
19. 叶静凡, 刘家莉, 董飞, 等. 无创正压通气治疗慢性阻塞性肺疾病急性加重并急性呼吸衰竭失败的危险因素分析. 华西医学, 2017, 32(11): 1702-1707.
20. 李文峰, 杨轲, 邓兴臣, 等. 无创通气治疗慢性阻塞性肺疾病急性发作合并Ⅱ型呼吸衰竭的疗效及影响因素. 海南医学, 2018, 29(13): 1787-1789.
21. 范小玉, 李秀. NPPV治疗AECOPD合并重度呼吸性酸中毒失败相关因素分析. 临床肺科杂志, 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. 冯力. Bipap治疗慢性阻塞性肺疾病伴中重度呼吸衰竭失败的危险因素分析. 河北医药, 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. 杜崇军. 无创正压通气治疗慢性阻塞性肺病急性加重期伴呼吸衰竭失败的相关因素分析. 第三军医大学学报, 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, 张近波, 张丽红, 等. 治疗COPD所致呼吸衰竭以改良GCS评分≥13分作为有创–无创序贯通气切换点的效果观察. 浙江医学, 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. Çiledağ A, Kaya A, Erçen Diken Ö, 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. 李坚, 张德厚, 孙丽萍, 等. 无创正压通气救治慢性阻塞性肺疾病呼吸衰竭后期失败的相关因素分析. 中国呼吸与危重监护杂志, 2003, 2(2): 100-103.
38. 宋宁燕, 徐劲松, 夏国际, 等. AECOPD合并Ⅱ型呼吸衰竭无创正压通气治疗早期失败的预警因素分析. 临床肺科杂志, 2011, 16(10): 1529-1531.
39. 翁燕娜, 韩云, 李芳. 急性呼吸衰竭无创正压通气治疗早期失败的预警因素分析. 广东医学, 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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