Liam M Hannan1, Giulio S Dominelli2, Yi-Wen Chen3, W Darlene Reid4, Jeremy Road5. 1. Institute for Breathing and Sleep, Austin Hospital, Heidelberg, Victoria, Australia; University of Melbourne, Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia; University of British Columbia, Respiratory Division and Department of Medicine, Vancouver, British Columbia, Canada. Electronic address: liamhannan1@yahoo.com.au. 2. University of British Columbia, Respiratory Division and Department of Medicine, Vancouver, British Columbia, Canada. Electronic address: dominell@alumni.ubc.ca. 3. University of British Columbia, Department of Physical Therapy, Vancouver, British Columbia, Canada. Electronic address: yiwenchen@alumni.ubc.ca. 4. University of British Columbia, Department of Physical Therapy, Vancouver, British Columbia, Canada. Electronic address: wdreid@mail.ubc.ca. 5. University of British Columbia, Respiratory Division and Department of Medicine, Vancouver, British Columbia, Canada. Electronic address: Jeremy.Road@vch.ca.
Abstract
BACKGROUND: This systematic review examined the effect of non-invasive positive pressure ventilation (NIPPV) on patient reported outcomes (PROs) and survival for individuals with or at risk of chronic respiratory failure (CRF). METHODS: Randomised controlled trials (RCTs) and prospective non-randomised studies in those treated with NIPPV for CRF were identified from electronic databases, reference lists and grey literature. Diagnostic groups included in the review were amyotrophic lateral sclerosis/motor neuron disease (ALS/MND), Duchenne muscular dystrophy (DMD), restrictive thoracic disease (RTD) and obesity hypoventilation syndrome (OHS). RESULTS: Eighteen studies were included and overall study quality was weak. Those with ALS/MND had improved somnolence and fatigue as well as prolonged survival with NIPPV. For OHS, improvements in somnolence and fatigue, dyspnoea and sleep quality were demonstrated, while for RTD, measures of dyspnoea, sleep quality, physical function and health, mental and emotional health and social function improved. There was insufficient evidence to form conclusions regarding the effect of NIPPV for those with DMD. CONCLUSIONS: This review has demonstrated that NIPPV influences PROs differently depending on the underlying cause of CRF. These findings may provide assistance to patients and clinicians to determine the relative costs and benefits of NIPPV therapy and also highlight areas in need of further research.
BACKGROUND: This systematic review examined the effect of non-invasive positive pressure ventilation (NIPPV) on patient reported outcomes (PROs) and survival for individuals with or at risk of chronic respiratory failure (CRF). METHODS: Randomised controlled trials (RCTs) and prospective non-randomised studies in those treated with NIPPV for CRF were identified from electronic databases, reference lists and grey literature. Diagnostic groups included in the review were amyotrophic lateral sclerosis/motor neuron disease (ALS/MND), Duchenne muscular dystrophy (DMD), restrictive thoracic disease (RTD) and obesity hypoventilation syndrome (OHS). RESULTS: Eighteen studies were included and overall study quality was weak. Those with ALS/MND had improved somnolence and fatigue as well as prolonged survival with NIPPV. For OHS, improvements in somnolence and fatigue, dyspnoea and sleep quality were demonstrated, while for RTD, measures of dyspnoea, sleep quality, physical function and health, mental and emotional health and social function improved. There was insufficient evidence to form conclusions regarding the effect of NIPPV for those with DMD. CONCLUSIONS: This review has demonstrated that NIPPV influences PROs differently depending on the underlying cause of CRF. These findings may provide assistance to patients and clinicians to determine the relative costs and benefits of NIPPV therapy and also highlight areas in need of further research.
Authors: Steffanie K B Veldhuis; Michiel H J Doff; Boudewijn Stegenga; Jellie A Nieuwenhuis; Peter J Wijkstra Journal: Sleep Breath Date: 2014-06-20 Impact factor: 2.816