Evidence map›Paper›PMID 38569922›Full record

SynthesisRespiratory care2024

Home Respiratory Strategies in Patients With COPD With Chronic Hypercapnic Respiratory Failure.

Tyler Pitre, Saad Abbasi, George V Kachkovski, Levi Burns, Peter Huan, Jasmine Mah, Claudia Crimi, Andrea Cortegiani, Bram Rochwerg, Dena Zeraatkar

Open access · greenAbstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in Respiratory care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 2 countries.

Tyler PitreDepartment of Respirology, University of Toronto, Toronto, Ontario, Canada.
Saad AbbasiDepartment of Respirology, University of Toronto, Toronto, Ontario, Canada; and Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
George V KachkovskiDepartment of Respirology, University of Toronto, Toronto, Ontario, Canada; and Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
Levi BurnsDepartment of Respirology, University of Toronto, Toronto, Ontario, Canada; and Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
Peter HuanDepartment of Respirology, University of Toronto, Toronto, Ontario, Canada; and Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
Jasmine MahDepartment of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Claudia CrimiDepartment of Clinical and Experimental Medicine, University of Catania, Catania, Italy; and Respiratory Medicine Unit, Policlinico "G. Rodolico-San Marco" University Hospital, Catania, Italy.
Andrea CortegianiDepartment of Surgical Oncological and Oral Science, University of Palermo, Palermo, Italy; and Department of Anesthesia, Intensive Care and Emergency, University Hospital Policlinico "Paolo Giaccone," Palermo, Italy.
Bram RochwergDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada; and Health Research Methods Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Dena ZeraatkarHealth Research Methods Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; and Department of Anesthesiology, McMaster University, Hamilton, Ontario, Canada. zeraatd@mcmaster.ca.
Hamilton Health Sciences · CAMcMaster University · CAAzienda Ospedaliera Universitaria Policlinico "Paolo Giaccone" di Palermo · ITDalhousie University · CAMarconi University · ITUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHome noninvasive ventilation (NIV) may improve chronic hypercarbia in COPD and patient-important outcomes. The efficacy of home high-flow nasal cannula (HFNC) as an alternative is unclear.

methodsWe searched MEDLINE, Embase, Cochrane CENTRAL, Scopus, and ClinicalTrials.gov for randomized trials of subjects from inception to March 31, 2023, and updated the search on July 14, 2023. We performed a frequentist network meta-analysis and assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. We analyzed randomized controlled trials (RCTs) comparing NIV, HFNC, or standard care in adult subjects with COPD with chronic hypercapnic respiratory failure. Outcomes included mortality, COPD exacerbations, hospitalizations, and quality of life (St George Respiratory Questionnaire [SGRQ]).

resultsWe analyzed 24 RCTs (1,850 subjects). We found that NIV may reduce the risk of death compared to standard care (relative risk 0.82 [95% CI 0.66-1.00]) and probably reduces exacerbations (relative risk 0.71 [95% CI 0.58-0.87]). HFNC probably reduces exacerbations compared to standard care (relative risk 0.77 [0.68-0.88]), but its effect on mortality is uncertain (relative risk 1.20 [95% CI 0.63-2.28]). HFNC probably improves SGRQ scores (mean difference -7.01 [95% CI -12.27 to -1.77]) and may reduce hospitalizations (relative risk 0.87 [0.69-1.09]) compared to standard care. No significant difference was observed between HFNC and NIV in reducing exacerbations.

conclusionsBoth NIV and HFNC reduce exacerbation risks in subjects with COPD compared to standard care. HFNC may offer advantages in improving quality of life.

Indexed as

Home Care ServicesHypercapniaNoninvasive VentilationPulmonary Disease, Chronic ObstructiveRespiratory InsufficiencyCannulaChronic DiseaseDisease ProgressionHospitalizationHumansOxygen Inhalation TherapyQuality of LifeRandomized Controlled Trials as TopicTreatment OutcomeCOPDHFNCnetwork meta-analysisNIV

Identifiers

PMID38569922
PMCPMC11549629
OpenAlexW4393863184

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.