Effect of non-invasive bi-level positive airway pressure ventilation combined with naloxone in the treatment of AECOPD complicated with pulmonary encephalopathy:a meta-analysis
10.3760/cma.j.issn.1674-6554.2013.06.017
- VernacularTitle:无创双水平正压通气联合纳洛酮治疗慢性阻塞性肺疾病急性加重并发肺性脑病的Meta分析
- Author:
Di QI
;
Jing HE
;
Yuan YE
;
Man LUO
;
Longhua FENG
;
Daoxin WANG
- Publication Type:Journal Article
- Keywords:
BiPAP;
Naloxone;
AECOPD;
Pulmonary encephalopathy;
Meta-analysis
- From:
Chinese Journal of Behavioral Medicine and Brain Science
2013;(6):533-536
- CountryChina
- Language:Chinese
-
Abstract:
Objective To review the effect of non-invasive bi-level positive airway pressure ventilation combined with naloxone in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with pulmonary encephalopathy (PE).Methods Related published studies involving BiPAP combined with naloxone in the treatment of AECOPD complicated with PE were recruited and identified from Pubmed,ISI Web of knowledge,CBM Disc,CNKI,Wanfang Data,and randomized controlled trails(RCTs) primarily collected were screened according to inclusive criteria and exclusive criteria.Valid data were extracted after quality evaluation for meta-analysis utilizing RevMan 5.2.Results A total of 10 Chinese RCTs were enrolled,including 697 patients (353 patients in experimental group while 343 patients in control group).The results of metaanalysis indicated that BiPAP combined with naloxone improved PaO2 (WMD =4.10,95％ CI (2.83,5.38),P＜0.00001),PH value(WMD =0.04,95％ CI (0.02,0.05),P ＜ 0.00001) and clinical efficiency rate (OR =3.58,95 ％ CI ((2.22,5.76),P ＜ 0.00001),and reduced PaCO2 (WMD =-5.78,95 ％ CI (-6.87,4.69),P ＜ 0.00001),re-endotracheal intubation rate (OR =0.19,95 ％ CI (0.11,0.35),P ＜ 0.00001),but failed to decrease mortality(OR =0.38,95％ CI (0.11,1.34),P =0.13) of patients with AECOPD complicated with PE.Conclusions BiPAP combined with naloxone play a protective role in enhancing arterial blood gas indexes,improving clinical efficiency rate and limiting re-endotracheal intubation rate.However,the mortality of patients cannot be reduced.
