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Noninvasive positive-pressure ventilation for children with acute asthma: a meta-analysis of randomized controlled

Jiajia Dai1, Libo Wang1, Fang Wang2

  • 1Department of Respiratory Medicine, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China.

Frontiers in Pediatrics
|May 15, 2023
PubMed

Insights

Noninvasive positive-pressure ventilation (NPPV) significantly improves outcomes for children with acute asthma, enhancing gas exchange and reducing symptoms. This meta-analysis suggests NPPV is a safe and effective treatment option for pediatric asthma patients.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Critical Care Medicine

Background:

  • Acute asthma is a common respiratory condition in children.
  • Clinical evidence for noninvasive positive-pressure ventilation (NPPV) in pediatric acute asthma is limited.
  • NPPV is a potential therapeutic option for improving respiratory support.

Purpose of the Study:

  • To systematically assess the effectiveness and safety of NPPV in treating children with acute asthma.
  • To provide a comprehensive meta-analysis of existing randomized controlled trials (RCTs).
  • To evaluate NPPV's impact on key clinical and physiological parameters in pediatric asthma.

Main Methods:

  • Systematic review and meta-analysis of 10 RCTs involving 558 children.
  • Searched major electronic databases (PubMed, Embase, Cochrane Library, Wanfang, CNKI).
  • Employed a random-effect model to pool results, accounting for heterogeneity.

Main Results:

  • NPPV significantly improved arterial blood gas parameters: oxygen saturation (MD: 4.28%), partial pressure of oxygen (MD: 10.61 mmHg), and partial pressure of carbon dioxide (MD: -6.29 mmHg).
  • NPPV was associated with reduced respiratory rate (MD: -12.90), improved symptom scores (SMD: -1.85), and shortened hospital stay (MD: -1.82 days).
  • No severe adverse events related to NPPV were reported, indicating a favorable safety profile.

Conclusions:

  • NPPV demonstrates significant benefits in improving gas exchange and clinical outcomes for children with acute asthma.
  • The findings suggest NPPV is a safe and effective alternative or adjunct to conventional treatment.
  • NPPV may reduce symptom severity and length of hospitalization in pediatric acute asthma cases.
Abstract

Keywords:
asthmachildrenefficacymeta-analysisnoninvasive positive-pressure 5entilation

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