The Use of Noninvasive Ventilation in Emergency Department Patients With Acute Cardiogenic Pulmonary Edema: A Systematic Review Sean P. Collins, MD,

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Presentation transcript:

The Use of Noninvasive Ventilation in Emergency Department Patients With Acute Cardiogenic Pulmonary Edema: A Systematic Review Sean P. Collins, MD, MSC, Lisa M. Mielniczuk, MD, Heather A. Whittingham, MD, Mark E. Boseley, MD, David R. Schramm, MD, Alan B. Storrow, MD Annals of Emergency Medicine Volume 48, Issue 3, Pages 260-269.e4 (September 2006) DOI: 10.1016/j.annemergmed.2006.01.038 Copyright © 2006 American College of Emergency Physicians Terms and Conditions

Figure 1 Flow diagram of selection process to obtain articles chosen for meta-analysis. RCT, Randomized clinical trial; CHF, congestive heart failure; CPAP, continuous positive airway pressure; NPPV, noninvasive positive pressure ventilation; MI, myocardial infarction. Annals of Emergency Medicine 2006 48, 260-269.e4DOI: (10.1016/j.annemergmed.2006.01.038) Copyright © 2006 American College of Emergency Physicians Terms and Conditions

Figure 2 Pooled RR for mortality: noninvasive ventilation versus standard care. NIV, Noninvasive ventilation. Annals of Emergency Medicine 2006 48, 260-269.e4DOI: (10.1016/j.annemergmed.2006.01.038) Copyright © 2006 American College of Emergency Physicians Terms and Conditions

Figure 3 Pooled RR for eventual intubation: noninvasive ventilation versus standard care. Annals of Emergency Medicine 2006 48, 260-269.e4DOI: (10.1016/j.annemergmed.2006.01.038) Copyright © 2006 American College of Emergency Physicians Terms and Conditions

Figure 4 Pooled RR for mortality: continuous positive airway pressure versus noninvasive positive pressure ventilation. Annals of Emergency Medicine 2006 48, 260-269.e4DOI: (10.1016/j.annemergmed.2006.01.038) Copyright © 2006 American College of Emergency Physicians Terms and Conditions

Figure 5 Pooled RR for eventual intubation: continuous positive airway pressure versus noninvasive positive pressure ventilation. Annals of Emergency Medicine 2006 48, 260-269.e4DOI: (10.1016/j.annemergmed.2006.01.038) Copyright © 2006 American College of Emergency Physicians Terms and Conditions

Figure E1 Funnel plot of noninvasive ventilation versus standard care: mortality. Annals of Emergency Medicine 2006 48, 260-269.e4DOI: (10.1016/j.annemergmed.2006.01.038) Copyright © 2006 American College of Emergency Physicians Terms and Conditions

Figure E2 Funnel plot of noninvasive ventilation versus standard care: intubation. Annals of Emergency Medicine 2006 48, 260-269.e4DOI: (10.1016/j.annemergmed.2006.01.038) Copyright © 2006 American College of Emergency Physicians Terms and Conditions

Figure E3 Funnel plot of continuous positive airway pressure versus noninvasive positive pressure ventilation: mortality. Annals of Emergency Medicine 2006 48, 260-269.e4DOI: (10.1016/j.annemergmed.2006.01.038) Copyright © 2006 American College of Emergency Physicians Terms and Conditions

Figure E4 Funnel plot of continuous positive airway pressure versus noninvasive positive pressure ventilation: intubation. Annals of Emergency Medicine 2006 48, 260-269.e4DOI: (10.1016/j.annemergmed.2006.01.038) Copyright © 2006 American College of Emergency Physicians Terms and Conditions

Figure E5 Funnel plot of continuous positive airway pressure versus standard care: intubation. Annals of Emergency Medicine 2006 48, 260-269.e4DOI: (10.1016/j.annemergmed.2006.01.038) Copyright © 2006 American College of Emergency Physicians Terms and Conditions

Figure E6 Funnel plot of continuous positive airway pressure versus standard care: mortality. Annals of Emergency Medicine 2006 48, 260-269.e4DOI: (10.1016/j.annemergmed.2006.01.038) Copyright © 2006 American College of Emergency Physicians Terms and Conditions

Figure E7 Funnel plot of noninvasive positive pressure ventilation versus standard care: mortality. Annals of Emergency Medicine 2006 48, 260-269.e4DOI: (10.1016/j.annemergmed.2006.01.038) Copyright © 2006 American College of Emergency Physicians Terms and Conditions

Figure E8 Funnel plot of noninvasive positive pressure ventilation versus standard care: intubation. Annals of Emergency Medicine 2006 48, 260-269.e4DOI: (10.1016/j.annemergmed.2006.01.038) Copyright © 2006 American College of Emergency Physicians Terms and Conditions