TY - JOUR T1 -头盔无创通气与面罩无创通气及高流量鼻插管治疗急性呼吸衰竭的比较:JF - European Respiratory Journal JO - Eur Respir J DO - 10.1188 /13993003.01269-2021 SP - 2101269 AU - Chaudhuri, Dipayan AU - Jinah, Rehman AU - Burns, Karen E.A. AU - Angriman, Federico AU - Ferreyro, Bruno AU - Munshi, Laveena AU - Goligher, Ewan AU - Scales, Damon AU - Cook, Deborah J. AU - Mauri, Tommaso AU - Rochwerg，尽管小型随机对照试验(rct)和观察性研究已经对头盔无创通气(NIV)进行了研究，但其作用仍不确定。我们进行了一项系统回顾和meta分析，以比较头盔无创通气与面罩无创通气或高流量鼻插管(HFNC)在急性呼吸衰竭中的效果。方法:我们搜索多个数据库，以确定rct和观察性研究报告的至少一种死亡率、插管、ICU住院时间、NIV时间、并发症或NIV治疗的舒适度。我们在rct中使用Cochrane ROB工具评估研究偏倚风险(ROB)，在观察性研究中使用渥太华-纽卡斯尔量表(Ottawa-Newcastle scale)评估研究偏倚风险(ROB)，并使用GRADE评估汇总证据的确定性。我们分别收集了16项rct (n=949)和8项观察性研究(n=396)的数据。低确定性证据表明，与面罩无氧通气相比，头盔无氧通气可降低低氧和高碳酸血症呼吸衰竭患者的死亡率(相对危险度(RR) 0.56, 95%置信区间(CI) 0.33 ~ 0.95)，可降低插管(RR 0.35, 95% CI(0.22 ~ 0.56))，但对无氧通气持续时间可能无影响。头盔对ICU住院时间和压疮发生的影响不确定。观察性研究的数据与上述发现一致，但确定性较低。根据低和非常低的确定度数据，头盔NIV与HFNC相比可减少插管次数，但其对死亡率的影响尚不确定。结论与面罩式无创通气相比，头盔式无创通气可降低死亡率和插管率; however, the effect of helmet compared to HFNC remains uncertain.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dipayan Chaudhuri has nothing to disclose.Conflict of interest: Rehman Jinah has nothing to disclose.Conflict of interest: Karen E.A. Burns has nothing to disclose.Conflict of interest: Federico Angriman has nothing to disclose.Conflict of interest: Bruno Ferreyro is supported by a Vanier Canada Graduate Scholarship.Conflict of interest: Laveena Munshi has nothing to disclose.Conflict of interest: Ewan Goligher has nothing to disclose.Conflict of interest: Damon Scales has nothing to disclose.Conflict of interest: Deborah J. Cook has nothing to disclose.Conflict of interest: Tommaso Mauri received personal fees from Drager, Fisher and Paykel, BBraun, all outside of the submitted work.Conflict of interest: Bram Rochwerg has nothing to disclose. ER -