SynthesisCritical care (London, England)2025
Physiological effects of noninvasive respiratory support strategies in adults with acute hypoxemic respiratory failure: a systematic review and network meta-analysis.
Synthesis in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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.
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Who cites it
2 citing papers in PubMed.
- The effect of asymmetrical vs. symmetrical high flow nasal cannula on inspiratory effort.Critical care (London, England) · 2026Article
- Non-Invasive Respiratory Support in "De Novo" Acute Hypoxemic Respiratory Failure: Which Technique Is Best?Medicina (Kaunas, Lithuania) · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn hypoxemic patients, the respective effects of noninvasive respiratory support strategies on lung injury determinants remain unclear, primarily due to the difficulty of obtaining standardized measurements for all interventions within the same study. We conducted a systematic review and network meta-analysis to assess the effects of noninvasive strategies on transpulmonary driving pressure and inspiratory effort in patients with acute hypoxemic respiratory failure.
methodsWe conducted a systematic search (Ovid MEDLINE, Embase, Scopus, and PubMed) and performed a network meta-analysis of physiological studies involving hypoxemic adults published up to February 16th, 2025. We included studies that assessed inspiratory effort with esophageal manometry under at least two noninvasive respiratory support strategies [standard oxygen, high-flow nasal oxygen (HFNO), noninvasive ventilation (NIV), and continuous positive airway pressure (CPAP)]. Outcomes included transpulmonary driving pressure, inspiratory effort per breath and per minute, respiratory rate, and gas exchange. Treatment effects are displayed as mean differences [95% confidence intervals].
resultsAmong 5876 citations, thirteen studies (n = 312 patients) were included (mean PaO
conclusionsNoninvasive strategies exert distinct physiological effects: HFNO and NIV reduce effort per minute, while only NIV decreases effort per breath but at the cost of increased driving pressure. CPAP has neutral effects on driving pressure and effort. CPAP and NIV provide greater improvements in oxygenation than HFNO. Individualized selection based on effort levels may help balance the benefits and risks of noninvasive support. PROSPERO REGISTRATION: CRD42024564035.
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