SynthesisIntensive care medicine2020
Do-not-intubate orders in patients with acute respiratory failure: a systematic review and meta-analysis.
Synthesis in Intensive care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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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.
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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.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Assessing palliative care practices in intensive care units and interpreting them using the lens of appropriate care concepts. An umbrella review.Intensive care medicine · 2024Pooled it
- Noninvasive respiratory support outside the intensive care unit for acute respiratory failure related to coronavirus-19 disease: a systematic review and meta-analysis.Critical care (London, England) · 2021Pooled it
- Serum zinc level independently predicts need for inpatient intubation among patients hospitalized with COVID-19: A prospective observational study.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2026Observational
- Temporal trends in post-extubation respiratory management and reintubation risk factors in Japan: A retrospective multicenter cohort study.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Debunking a one-size-fits-all in acute respiratory failure: lessons from the RENOVATE trial.Journal of thoracic disease · 2025Article
- Role of Non-Invasive Ventilation in Elderly Patients: Therapeutic Opportunity or Medical Futility? An Updated Narrative Review.Medicina (Kaunas, Lithuania) · 2025Review
- The interpretation of code status concept among pediatric health care workers, a multicenter cross sectional study across Lebanon.Frontiers in medicine · 2025Article
- Oxygen therapy and noninvasive respiratory supports in acute hypoxemic respiratory failure: a narrative review.Annals of intensive care · 2024Review
- The Predictive Performance of Risk Scores for the Outcome of COVID-19 in a 2-Year Swiss Cohort.Biomedicines · 2024Article
- Effect of high flow nasal oxygen on inspiratory effort of patients with acute hypoxic respiratory failure and do not intubate orders.Internal and emergency medicine · 2024Article
- Indian Society of Critical Care Medicine and Indian Association of Palliative Care Expert Consensus and Position Statements for End-of-life and Palliative Care in the Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Use of non-invasive respiratory supports in high-intensity internal medicine setting during the first two waves of the COVID-19 pandemic emergency in Italy: a multicenter, real-life experience.Internal and emergency medicine · 2023Article
- A Survey for Assessment of Practical Aspects of End-of-life Practices across Indian Intensive Care Units.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023Article
- 'Do-not-intubate' orders in patients assisted by noninvasive respiratory support for acute hypoxaemic failure caused by coronavirus disease 2019; a systematic review and meta-analysis.European journal of anaesthesiology and intensive care · 2023Article
- Prognostic factors for advanced lung cancer patients with do-not-intubate order in intensive care unit: a retrospective study.BMC pulmonary medicine · 2022Article
- Focus on better care and ethics: Are medical ethics lagging behind the development of new medical technologies?Intensive care medicine · 2020Article
- Fluid resuscitation of at least 30 mL/kg was not associated with decreased mortality in patients with infection, signs of hypoperfusion, and a do-not-intubate order.Acute medicine & surgeryArticle
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo assess the rates and variability of do-not-intubate orders in patients with acute respiratory failure.
methodsWe conducted a systematic review of observational studies that enrolled adult patients with acute respiratory failure requiring noninvasive ventilation or high-flow nasal cannula oxygen from inception to 2019.
resultsTwenty-six studies evaluating 10,755 patients were included. The overall pooled rate of do-not-intubate orders was 27%. The pooled rate of do-not-intubate orders in studies from North America was 14% (range 9-22%), from Europe was 28% (range 13-58%), and from Asia was 38% (range 9-83%), p = 0.001. Do-not-intubate rates were higher in studies with higher patient age and in studies where do-not-intubate decisions were made without reported patient/family input. There were no significant differences in do-not-intubate orders according to illness severity, observed mortality, malignancy comorbidity, or methodological quality. Rates of do-not-intubate orders increased over time from 9% in 2000-2004 to 32% in 2015-2019. Only 12 studies (46%) reported information about do-not-intubate decision-making processes. Only 4 studies (15%) also reported rates of do-not-resuscitate.
conclusionsOne in four patients with acute respiratory failure (who receive noninvasive ventilation or high-flow nasal cannula oxygen) has a do-not-intubate order. The rate of do-not-intubate orders has increased over time. There is high inter-study variability in do-not-intubate rates-even when accounting for age and illness severity. There is high variability in patient/family involvement in do-not-intubate decision making processes. Few studies reported differences in rates of do-not-resuscitate and do-not-intubate-even though recovery is very different for acute respiratory failure and cardiac arrest.
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