SynthesisBMC pulmonary medicine2025
Efficacy of non-invasive ventilation in chronic obstructive pulmonary disease management: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in BMC pulmonary medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Cardiovascular Risk During the 90-Day Vulnerable Window After COPD Exacerbations: A Narrative Review.Life (Basel, Switzerland) · 2026Review
- Neurocognitive and neurophysiological consequences of sleep-disordered breathing in bronchiectasis: the role of respiratory rehabilitation.Frontiers in rehabilitation sciences · 2026Review
- Development and internal-external validation of a machine learning-based risk prediction model for multidrug resistance in mechanically ventilated ICU patients with chronic obstructive pulmonary disease.Frontiers in medicine · 2026Article
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Authors and funding
2 authors.
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Abstract
backgroundChronic obstructive pulmonary disease (COPD) poses significant challenges in respiratory care, with exacerbations and impaired gas exchange being major concerns. Non-invasive ventilation (NIV) has emerged as a valuable therapeutic approach, mitigating respiratory distress and hospitalization risks without the complications associated with invasive ventilation. This systematic review and meta-analysis aim to consolidate evidence from randomized controlled trials (RCTs) to elucidate the therapeutic benefits of NIV across various stages of COPD, providing insights into its potential to improve patient outcomes.
methodsWe conducted a comprehensive systematic review and meta-analysis of RCTs using PubMed, Embase, Scopus and Cochrane databases that compared NIV with standard care (including oxygen therapy, medications, and nasal cannula oxygen delivery) in patients with COPD at various stages, including stable and post-exacerbation. The primary outcomes of interest were mortality outcomes (MO), intubation and exacerbation outcomes (IAEO), and arterial blood gas outcomes (ABGO). Odds ratios (ORs) and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated as summary statistics. Heterogeneity was assessed using the I² statistic.
resultsOur meta-analysis of 16 RCTs comprising 1,369 patients demonstrated significant benefits of non-invasive ventilation (NIV) in both post-exacerbation chronic obstructive pulmonary disease (PECOPD) and stable COPD patients. The studies demonstrated a low risk of bias and exhibited low heterogeneity (I² statistic) due to consistent interventions, comparators, and patient characteristics. Pooled analysis revealed statistically significant reductions in MO [PECOPD: OR 0.52 (0.43–0.64), p < 0.001; stable COPD: OR 0.56 (0.44–0.71), p < 0.001], intubation frequency [PECOPD: OR 0.64 (0.54–0.76), p < 0.001; stable COPD: OR 0.43 (0.31–0.60), p < 0.001], exacerbation frequency [PECOPD: OR 0.47 (0.38–0.59), p < 0.001; stable COPD: OR 0.37 (0.25–0.53), p < 0.001], and PaCO2 levels [PECOPD: RR 0.55 (0.45–0.67), p < 0.001; stable COPD: RR 0.56 (0.42–0.74), p < 0.001], as well as significant increases in PaO2 levels [PECOPD: RR 0.52 (0.43–0.64), p < 0.001; stable COPD: RR 0.61 (0.48–0.77), p < 0.001].
conclusionsOur meta-analysis demonstrates that NIV significantly improves clinical outcomes in patients with COPD, including reduced mortality, intubation frequency, exacerbation frequency and PaCO2 levels and significant increase in PaO2 levels. These findings support the use of NIV as a valuable therapeutic strategy in managing patients with COPD. However, further studies are warranted to refine patient selection and optimize NIV protocols, thereby maximizing therapeutic benefits.
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