Carolina da Cunha-Correia, Mylana Dandara Pereira Gama, Pedro Nogueira Fontana, Francisca Goreth Malheiro Moraes Fantini, Gilmar Fernandes Prado, Mário Emílio Teixeira Dourado Júnior, Paulo Adriano Schwingel
{"title":"无创机械通气辅助治疗肌萎缩侧索硬化:一项系统综述。","authors":"Carolina da Cunha-Correia, Mylana Dandara Pereira Gama, Pedro Nogueira Fontana, Francisca Goreth Malheiro Moraes Fantini, Gilmar Fernandes Prado, Mário Emílio Teixeira Dourado Júnior, Paulo Adriano Schwingel","doi":"10.1590/1516-3180.2022.0470.R1.100423","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Respiratory failure is the most common cause of death in patients with amyotrophic lateral sclerosis (ALS), and morbidity is related to poor quality of life (QOL). Non-invasive ventilation (NIV) may be associated with prolonged survival and QOL in patients with ALS.</p><p><strong>Objectives: </strong>To assess whether NIV is effective and safe for patients with ALS in terms of survival and QOL, alerting the health system.</p><p><strong>Design and setting: </strong>Systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting standards using population, intervention, comparison, and outcome strategies.</p><p><strong>Methods: </strong>The Cochrane Library, CENTRAL, MEDLINE, LILACS, EMBASE, and CRD databases were searched based on the eligibility criteria for all types of studies on NIV use in patients with ALS published up to January 2022. Data were extracted from the included studies, and the findings were presented using a narrative synthesis.</p><p><strong>Results: </strong>Of the 120 papers identified, only 14 were related to systematic reviews. After thorough reading, only one meta-analysis was considered eligible. In the second stage, 248 studies were included; however, only one systematic review was included. The results demonstrated that NIV provided relief from the symptoms of chronic hypoventilation, increased survival, and improved QOL compared to standard care. These results varied according to clinical phenotype.</p><p><strong>Conclusions: </strong>NIV in patients with ALS improves the outcome and can delay the indication for tracheostomy, reducing expenditure on hospitalization and occupancy of intensive care unit beds.</p><p><strong>Systematic review registration: </strong>PROSPERO database: CRD42021279910 - https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=279910.</p>","PeriodicalId":49574,"journal":{"name":"Sao Paulo Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328442/pdf/","citationCount":"0","resultStr":"{\"title\":\"Noninvasive mechanical ventilation assistance in amyotrophic lateral sclerosis: a systematic review.\",\"authors\":\"Carolina da Cunha-Correia, Mylana Dandara Pereira Gama, Pedro Nogueira Fontana, Francisca Goreth Malheiro Moraes Fantini, Gilmar Fernandes Prado, Mário Emílio Teixeira Dourado Júnior, Paulo Adriano Schwingel\",\"doi\":\"10.1590/1516-3180.2022.0470.R1.100423\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Respiratory failure is the most common cause of death in patients with amyotrophic lateral sclerosis (ALS), and morbidity is related to poor quality of life (QOL). Non-invasive ventilation (NIV) may be associated with prolonged survival and QOL in patients with ALS.</p><p><strong>Objectives: </strong>To assess whether NIV is effective and safe for patients with ALS in terms of survival and QOL, alerting the health system.</p><p><strong>Design and setting: </strong>Systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting standards using population, intervention, comparison, and outcome strategies.</p><p><strong>Methods: </strong>The Cochrane Library, CENTRAL, MEDLINE, LILACS, EMBASE, and CRD databases were searched based on the eligibility criteria for all types of studies on NIV use in patients with ALS published up to January 2022. Data were extracted from the included studies, and the findings were presented using a narrative synthesis.</p><p><strong>Results: </strong>Of the 120 papers identified, only 14 were related to systematic reviews. After thorough reading, only one meta-analysis was considered eligible. In the second stage, 248 studies were included; however, only one systematic review was included. The results demonstrated that NIV provided relief from the symptoms of chronic hypoventilation, increased survival, and improved QOL compared to standard care. These results varied according to clinical phenotype.</p><p><strong>Conclusions: </strong>NIV in patients with ALS improves the outcome and can delay the indication for tracheostomy, reducing expenditure on hospitalization and occupancy of intensive care unit beds.</p><p><strong>Systematic review registration: </strong>PROSPERO database: CRD42021279910 - https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=279910.</p>\",\"PeriodicalId\":49574,\"journal\":{\"name\":\"Sao Paulo Medical Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328442/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sao Paulo Medical Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1590/1516-3180.2022.0470.R1.100423\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sao Paulo Medical Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1590/1516-3180.2022.0470.R1.100423","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Noninvasive mechanical ventilation assistance in amyotrophic lateral sclerosis: a systematic review.
Background: Respiratory failure is the most common cause of death in patients with amyotrophic lateral sclerosis (ALS), and morbidity is related to poor quality of life (QOL). Non-invasive ventilation (NIV) may be associated with prolonged survival and QOL in patients with ALS.
Objectives: To assess whether NIV is effective and safe for patients with ALS in terms of survival and QOL, alerting the health system.
Design and setting: Systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting standards using population, intervention, comparison, and outcome strategies.
Methods: The Cochrane Library, CENTRAL, MEDLINE, LILACS, EMBASE, and CRD databases were searched based on the eligibility criteria for all types of studies on NIV use in patients with ALS published up to January 2022. Data were extracted from the included studies, and the findings were presented using a narrative synthesis.
Results: Of the 120 papers identified, only 14 were related to systematic reviews. After thorough reading, only one meta-analysis was considered eligible. In the second stage, 248 studies were included; however, only one systematic review was included. The results demonstrated that NIV provided relief from the symptoms of chronic hypoventilation, increased survival, and improved QOL compared to standard care. These results varied according to clinical phenotype.
Conclusions: NIV in patients with ALS improves the outcome and can delay the indication for tracheostomy, reducing expenditure on hospitalization and occupancy of intensive care unit beds.
期刊介绍:
Published bimonthly by the Associação Paulista de Medicina, the journal accepts articles in the fields of clinical health science (internal medicine, gynecology and obstetrics, mental health, surgery, pediatrics and public health). Articles will be accepted in the form of original articles (clinical trials, cohort, case-control, prevalence, incidence, accuracy and cost-effectiveness studies and systematic reviews with or without meta-analysis), narrative reviews of the literature, case reports, short communications and letters to the editor. Papers with a commercial objective will not be accepted.