Adverse Events in Non-invasive Ventilation Approaches: Systematic Review.

Area of Science:

• Respiratory Medicine
• Critical Care Medicine
• Pulmonary Physiology

Background:

• Non-invasive ventilation (NIV) is crucial for respiratory failure management.
• NIV offers advantages over invasive mechanical ventilation but carries risks.
• Adverse events associated with NIV can negatively impact patient outcomes.

Purpose of the Study:

• To systematically review the types, frequencies, and clinical consequences of complications linked to NIV.
• To evaluate the impact of different NIV interfaces on adverse event rates.
• To identify strategies for mitigating NIV-related complications.

Main Methods:

• Systematic literature search of PubMed, EMBASE, and Cochrane Library (2000-Feb 2023).
• Included randomized controlled trials, observational cohorts, and systematic reviews.
• Analysis of 32 studies with approximately 6,000 adult patients with respiratory failure.

Main Results:

• Common NIV complications include physiological (hypercapnia, hypoxemia), mechanical (skin breakdown, air leaks), and patient-related (discomfort, anxiety).
• Face masks showed higher rates of air leaks and intolerance compared to helmet interfaces.
• Helmet interfaces and newer ventilator technologies demonstrated reduced adverse event rates.

Conclusions:

• NIV-related complications are frequent and can compromise treatment effectiveness.
• Structured monitoring, early intervention, and multidisciplinary care are vital for optimizing NIV outcomes.
• Further research is needed to enhance patient comfort and minimize complications during NIV therapy.