SynthesisBMJ (Clinical research ed.)2009
Use of non-invasive ventilation to wean critically ill adults off invasive ventilation: meta-analysis and systematic review.
Synthesis in BMJ (Clinical research ed.), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Invasive versus non-invasive ventilation for acute respiratory failure in neuromuscular disease and chest wall disorders.The Cochrane database of systematic reviews · 2017Pooled it
- Noninvasive ventilation as a weaning strategy for mechanical ventilation in adults with respiratory failure: a Cochrane systematic review.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2014Pooled it
- Noninvasive positive-pressure ventilation as a weaning strategy for intubated adults with respiratory failure.The Cochrane database of systematic reviews · 2013Pooled it
- Use of weaning protocols for reducing duration of mechanical ventilation in critically ill adult patients: Cochrane systematic review and meta-analysis.BMJ (Clinical research ed.) · 2011Pooled it
- Noninvasive ventilation immediately after extubation improves weaning outcome after acute respiratory failure: a randomized controlled trial.Critical care (London, England) · 2013Trial
- Nutritional adequacy in critically ill adults receiving noninvasive ventilation: A descriptive cohort study.JPEN. Journal of parenteral and enteral nutrition · 2025Article
- Prolonged weaning from mechanical ventilation: who, what, when and how?Breathe (Sheffield, England) · 2024Review
- Pulmonary function testing dataset of pressure and flow, dynamic circumference, heart rate, and aeration monitoring.Data in brief · 2024Article
- CPAP pressure and flow data at 2 positive pressure levels and multiple controlled breathing rates from a trial of 30 adults.BMC research notes · 2022Article
- High-flow nasal cannula oxygen therapy and noninvasive ventilation for preventing extubation failure during weaning from mechanical ventilation assessed by lung ultrasound score: A single-center randomized study.World journal of emergency medicine · 2021Article
- Article
- Looking under the bonnet of patient-ventilator asynchrony during noninvasive ventilation: does it add value?ERJ open research · 2017Article
- Successful Extubation After Weaning Failure by Noninvasive Ventilation in Patients With Neuromuscular Disease: Case Series.Annals of rehabilitation medicine · 2017Article
- High-flow nasal cannula oxygen therapy: more than a higher amount of oxygen delivery.Journal of thoracic disease · 2016Article
- Ventilator associated pneumonia following liver transplantation: Etiology, risk factors and outcome.World journal of transplantation · 2016Article
- Year in review 2013: Critical Care--respirology.Critical care (London, England) · 2014Review
- Noninvasive ventilation in acute respiratory failure.International journal of chronic obstructive pulmonary disease · 2014Review
- Managing the apparent and hidden difficulties of weaning from mechanical ventilation.Intensive care medicine · 2013Review
- The role of non-invasive positive pressure ventilation in post-extubation respiratory failure: An evaluation using meta-analytic techniques.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2013Article
- Invasive and non-invasive mechanical ventilation.Medicine (Abingdon, England : UK ed.) · 2012Review
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo summarise the evidence for early extubation with immediate application of non-invasive ventilation compared with continued invasive weaning on important outcomes in intubated adults with respiratory failure.
designSystematic review and meta-analysis of randomised and quasi-randomised controlled trials.
settingIntensive care units.
participantsCritically ill adults receiving invasive ventilation. Study selection criteria We searched Medline, Embase, and CENTRAL, proceedings from four conferences, and reference lists of relevant studies to identify relevant trials. Two reviewers independently selected trials, assessed trial quality, and abstracted data.
resultsWe identified 12 trials enrolling 530 participants, mostly with chronic obstructive pulmonary disease. Compared with invasive weaning, non-invasive weaning was significantly associated with reduced mortality (relative risk 0.55, 95% confidence interval 0.38 to 0.79), ventilator associated pneumonia (0.29, 95% 0.19 to 0.45), length of stay in intensive care unit (weighted mean difference -6.27 days, -8.77 to -3.78) and hospital (-7.19 days, -10.80 to -3.58), total duration of ventilation, and duration of invasive ventilation. Non-invasive weaning had no effect on weaning failures or weaning time. Benefits on mortality and weaning failures were non-significantly greater in trials that exclusively enrolled patients with chronic obstructive pulmonary disease versus mixed populations.
conclusionsCurrent trials in critically ill adults show a consistent positive effect of non-invasive weaning on mortality and ventilator associated pneumonia, though the net clinical benefits remain to be fully elucidated. Non-invasive ventilation should preferentially be used in patients with chronic obstructive pulmonary disease in a highly monitored environment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.