Canadian Journal of Respiratory Therapy最新文献

{"title":"Comparison of physical activity levels in people with chronic obstructive pulmonary disease and healthy subjects residing in hypobaric hypoxia environments.","authors":"Wilder A Villamil-Parra","doi":"10.29390/001c.122163","DOIUrl":"10.29390/001c.122163","url":null,"abstract":"<p><strong>Background: </strong>The reduced level of physical activity in individuals with chronic obstructive pulmonary disease (COPD) is associated with disease severity; however, mild COPD may or may not decrease individuals' physical fitness. Currently, it is unknown whether high-altitude hypoxia is a modifying factor of physical activity levels in COPD compared to healthy subjects.</p><p><strong>Objective: </strong>To compare physical activity levels in individuals with COPD versus healthy subjects residing in high-altitude environments.</p><p><strong>Methods: </strong>Individuals with COPD GOLD 1(A, B) and control subjects residing at high altitudes (>2500m) were studied. Physical activity level was measured for seven days using triaxial accelerometry. Measurement variables included METs/hour, energy expenditure in kcal/hour, total daily energy expenditure, and number of steps per day.</p><p><strong>Results: </strong>Daily caloric expenditure associated with physical activity showed only a slight decrease (3.1%) in COPD patients compared to the control group; there was a significant 61.32% lower hourly calorie consumption rate in the COPD group. Additionally, COPD patients exhibited lower MET/hour (9.64% difference) and a substantial difference in the number of steps per day, with 139.41% fewer steps compared to the control group.</p><p><strong>Conclusion: </strong>COPD patients in hypobaric hypoxia environments exhibit significantly lower levels of physical activity compared to healthy individuals. Altitude hypoxia contributes to low levels of physical activity in both COPD patients and healthy subjects.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"103-111"},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volatile gas scavenging in the paediatric intensive care unit: Occupational health and safety assessment.","authors":"Katherine Reise, Jason Macartney, Richard La, Angela Jerath, Marat Slessarev, Brian H Cuthbertson, Saptharishi Lalgudi Ganesan, Nicole K McKinnon","doi":"10.29390/001c.118513","DOIUrl":"10.29390/001c.118513","url":null,"abstract":"<p><strong>Introduction: </strong>The use of volatile anesthetic agents in the paediatric intensive care unit (PICU) is experiencing increased interest since the availability of the miniature vapourizing device. However, the effectiveness of scavenging systems in the presence of humidifiers in the ventilator circuit is unknown.</p><p><strong>Approach methods: </strong>We performed a bench study to evaluate the effectiveness of the Deltasorb® scavenging system in the presence of isoflurane and active humidity by simulating both infant and child ventilator test settings. A total of four ventilators were set to ventilate test lungs, all with active humidity and a Deltasorb scavenging canister collecting exhaled ventilation gas. Two ventilators also had isoflurane delivered using the Anesthesia Conserving Device- small (ACD®-S) on the inspiratory limb (also called alternative ventilator configuration). We performed instantaneous measurements of isoflurane and continuous sampling with passive badges to measure average environmental exposure over a test period of 6.5 hours. Scavenging canisters were returned to the company, where desorption analysis showed the volume of water and isoflurane captured in each canister.</p><p><strong>Findings: </strong>Both instantaneous point sampling and diffusive sampling results were below the occupational exposure limit confirming safety. The canisters collected both isoflurane and a portion of the water vapour delivered; the percentage of captured water and isoflurane collected in infants was higher than the child ventilator test settings.</p><p><strong>Practice implications conclusion: </strong>The tested scavenging configuration was effective in maintaining a safe working environment with active humidity and inspiratory limb (alternative) ventilator configuration of the the miniature vapourizing device.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"95-102"},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the impact of long-term inhaled corticosteroid therapy on patients with COVID-19 and coexisting chronic lung disease: A multicenter retrospective cohort study.","authors":"Adela Pina Belmonte, Manuel Madrazo, Laura Piles, Manuel Rubio-Rivas, Lucía de Jorge Huerta, María Gómez Antúnez, Juan Francisco López Caleya, Francisco Arnalich Fernández, Martin Gericó-Aseguinolaza, Paula Maria Pesqueira Fontan, Nicolás Rhyman, Marina Prieto Dehesa, Juan Luis Romero Cabrera, Gema María García García, Gonzalo García-Casasola, Ane Labirua-Iturburu Ruiz, Francisco Javier Carrasco-Sánchez, Sara Martínez Hernández, Maria de Los Reyes Pascual Pérez, José López Castro, José Luis Serrano Carrillo de Albornoz, José F Varona, Ricardo Gómez-Huelgas, Juan-Miguel Antón-Santos, Carlos Lumbreras-Bermejo","doi":"10.29390/001c.118514","DOIUrl":"10.29390/001c.118514","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic lung disease (CLD), such as asthma or chronic obstructive pulmonary disease, were expected to have an increased risk of clinical manifestations and severity of COVID-19. However, these comorbidities have been reported less frequently than expected. Chronic treatment with inhaled corticosteroids (ICS) may impact the clinical course of COVID-19. The main objective of this study is to know the influence of chronic treatment with ICS on the prognosis of COVID-19 hospitalized patients with CLD.</p><p><strong>Methods: </strong>A multicenter retrospective cohort study was designed, including patients hospitalized with COVID-19. Epidemiological and clinical data were collected at admission and at seven days, and clinical outcomes were collected. Patients with CLD with and without chronic treatment with ICS were compared.</p><p><strong>Results: </strong>Two thousand five hundred ninety-eight patients were included, of which 1,171 patients had a diagnosis of asthma and 1,427 of COPD (53.37% and 41.41% with ICS, respectively). No differences were found in mortality, transfer to ICU, or development of moderate-severe ARDS. Patients with chronic ICS had a longer hospital stay in both asthma and COPD patients (9 vs. 8 days, <i>p =</i> 0.031 in asthma patients), (11 vs. 9 days, <i>p =</i> 0.018 in COPD patients); although they also had more comorbidity burden.</p><p><strong>Conclusions: </strong>Patients with chronic inhaled corticosteroids had longer hospital stays and more chronic comorbidities, measured by the Charlson comorbidity index, but they did not have more severe disease at admission, evaluated with qSOFA and PSI scores. Chronic treatment with inhaled corticosteroids had no influence on the prognosis of patients with chronic lung disease and COVID-19.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"86-94"},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of adding a six-month Pilates exercise program to three months of traditional community-based pulmonary rehabilitation in individuals with COPD: a prospective cohort study.","authors":"Marisela Barbosa, Cristina A de Melo, Rui Torres","doi":"10.29390/001c.117966","DOIUrl":"10.29390/001c.117966","url":null,"abstract":"<p><strong>Introduction: </strong>Pilates exercise may complement traditional pulmonary rehabilitation in individuals with chronic obstructive pulmonary disease (COPD). The objective was to analyze the effects of adding a six-month Pilates exercise program to a three-month pulmonary rehabilitation for individuals with COPD.</p><p><strong>Methods: </strong>Thirty-five participants with COPD (GOLD B) were assigned to the intervention (n=14) or control (n=21) group. Both groups received an initial three months of a pulmonary rehabilitation program. The intervention group further underwent six months of pilates. Participants were evaluated at baseline and at three, six, and nine months. Lung function and strength of respiratory muscles were defined as primary outcomes. Secondary outcomes included cardiac, physical function, and exacerbation episodes.</p><p><strong>Results: </strong>There were no consistent statistically significant differences between groups for the lung function outcomes (<i>p</i><0.05). Maximal inspiratory and expiratory pressure increased significantly at three months in both groups (<i>p</i><0.05). It was significantly superior in the intervention group at nine months for maximal inspiratory pressure (<i>p</i>=0.005) and six and nine months for maximal expiratory pressure (<i>p</i>=0.027 and <i>p</i><0.001, respectively). Changes in muscle strength (knee extension and handgrip) were comparable between groups (<i>p</i>>0.05), but exercise-induced fatigue and balance were significantly superior in the intervention group at the six- and nine-month follow-ups (<i>p</i><0.05).</p><p><strong>Discussion: </strong>Pilates exercise programs may be implemented to augment traditional pulmonary rehabilitation with the goal of improving the strength of respiratory muscles.</p><p><strong>Conclusion: </strong>Adding a Pilates exercise program to pulmonary rehabilitation resulted in superior strength of respiratory muscles, higher resistance to exercise-induced fatigue, and improved balance.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"68-85"},"PeriodicalIF":0.0,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11144029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141198999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proceedings from the Canadian Society of Respiratory Therapists Annual Conference May 3-5, 2024","authors":"","doi":"10.29390/001c.117111","DOIUrl":"https://doi.org/10.29390/001c.117111","url":null,"abstract":"Conference abstracts","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140982191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-care lung ultrasound in detecting pneumonia: A systematic review.","authors":"Iqra Abid, Nadia Qureshi, Nicola Lategan, Simon Williams, Sidra Shahid","doi":"10.29390/001c.92182","DOIUrl":"10.29390/001c.92182","url":null,"abstract":"<p><strong>Purpose: </strong>Limited evidence exists to assess the sensitivity, specificity, and accuracy of point-of-care lung ultrasound (LUS) across all age groups. This review aimed to investigate the benefits of point-of-care LUS for the early diagnosis of pneumonia compared to traditional chest X-rays (CXR) in a subgroup analysis including pediatric, adult, and geriatric populations.</p><p><strong>Material and methods: </strong>This systematic review examined systematic reviews, meta-analyses, and original research from 2017 to 2021, comparing point-of-care LUS and CXR in diagnosing pneumonia among adults, pediatrics and geriatrics. Studies lacking direct comparison or exploring diseases other than pneumonia, case reports, and those examining pneumonia secondary to COVID-19 variants were excluded. The search utilized PubMed, Google Scholar, and Cochrane databases with specific search strings. The study selection, conducted by two independent investigators, demonstrated an agreement by the Kappa index, ensuring reliable article selection. The QUADAS-2 tool assessed the selected studies for quality, highlighting risk of bias and applicability concerns across key domains. Statistical analysis using Stata Version 16 determined pooled sensitivity and specificity via a bivariate model, emphasizing LUS and CXR diagnostic capabilities. Additionally, RevMan 5.4.1 facilitated the calculation of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), offering insights into diagnostic accuracy.</p><p><strong>Results: </strong>The search, conducted across PubMed, Google Scholar, and Cochrane Library databases by two independent investigators, initially identified 1045 articles. Following screening processes, 12 studies comprised a sample size of 2897. LUS demonstrated a likelihood ratio of 5.09, a specificity of 81.91%, and a sensitivity of 92.13% in detecting pneumonia in pediatric, adult, and geriatric patients, with a p-value of 0.0002 and a 95% confidence interval, indicating diagnostic accuracy ranging from 84.07% to 96.29% when compared directly to CXR.</p><p><strong>Conclusion: </strong>Our review supports that LUS can play a valuable role in detecting pneumonia early with high sensitivity, specificity, and diagnostic accuracy across diverse patient demographics, including pediatric, adult, and geriatric populations. Since it overcomes most of the limitations of CXR and other diagnostic modalities, it can be utilized as a diagnostic tool for pneumonia for all age groups as it is a safe, readily available, and cost-effective modality that can be utilized in an emergency department, intensive care units, wards, and clinics by trained respiratory care professionals.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"37-48"},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10830142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Making respiratory care safe for neonatal and paediatric intensive care unit staff: mitigation strategies and use of filters.","authors":"Bradley G Carter, Edward Harcourt, Alexandra Harris, Michael Zampetti, Trevor Duke, David Tingay","doi":"10.29390/001c.91262","DOIUrl":"10.29390/001c.91262","url":null,"abstract":"<p><strong>Background: </strong>Many medical devices in pediatric and newborn intensive care units can potentially expose healthcare workers (HCWs) and others to transmission of respiratory and other viruses and bacteria. Such fomites include ventilators, nebulizers, and monitoring equipment.</p><p><strong>Approach: </strong>We report the general, novel approach we have taken to identify and mitigate these risks and to protect HCWs, visitors and patients from exposure while maintaining the optimal performance of such respiratory equipment.</p><p><strong>Findings: </strong>The approach combined a high level of personal protective equipment (PPE), strict hand hygiene, air filtration and air conditioning and other relevant viral risk mitigation guidelines. This report describes the experiences from the SARS-CoV-2 pandemic to provide a reference framework that can be applied generally. The steps we took consisted of auditing our equipment and processes to identify risk through sources of potentially contaminated gas that may contain aerosolized virus, seeking advice and liaising with suppliers/manufacturers, devising mitigation strategies using indirect and direct approaches (largely filtering), performing tests on equipment to verify proper function and the absence of negative impacts and the development and implementation of relevant procedures and practices. We had a multidisciplinary team to guide the process. We monitored daily for hospital-acquired infections among staff caring for SARS-CoV-2 patients.</p><p><strong>Conclusion: </strong>Our approach was successful as we have continued to offer optimal intensive care to our patients, and we did not find any healthcare worker who was infected through the course of caring for patients at the bedside. The lessons learnt will be of benefit to future local outbreaks or pandemics.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"13-27"},"PeriodicalIF":0.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positive airway pressure therapy adherence and outcomes in obstructive sleep apnea: An exploratory longitudinal retrospective randomized chart review","authors":"Daniel Stevens, Michaela Title, Kathleen Spurr, Debra Morrison","doi":"10.29390/001c.92080","DOIUrl":"https://doi.org/10.29390/001c.92080","url":null,"abstract":"Positive airway pressure (PAP) therapy is prescribed to patients with obstructive sleep apnea (OSA). A commonly used definition for PAP therapy adherence is based upon the minimum requirements to receive Medicare coverage in the US, defined as PAP usage of four or more hours per night on 70 percent of nights for at least 30 consecutive days. However, little evidence exists to support this definition for PAP therapy adherence. Therefore, the present study sought to determine the efficacy of the present definition of PAP therapy adherence on longitudinal outcomes in patients with OSA, using objectively measured PAP device usage time. An exploratory longitudinal, retrospective, randomized chart review was done to assess clinical outcomes between patients with OSA who were defined as PAP therapy adherent (n=50) and non-adherent (n=50) during an eight-year observation period. No significant differences were shown between groups for mortality, hospitalizations, or development of co-morbidities during the observation period. However, logistic regression showed significantly higher odds of adherence in male patients compared to female patients (OR=8.519; 95%CI=1.301–55.756; p=0.025) and significantly lower odds of adherence in patients with higher normal (OR=0.039; 95%CI=0.005–0.392; p=0.003), mild excessive (OR=0.039; 95%CI=0.003–0.517; p=0.014), and severe excessive (OR=0.088; 95%CI=0.012–0.635; p=0.016) daytime sleepiness compared to patients with lower normal daytime sleepiness. An increasing number of hospitalizations also corresponded with a significant decrease in odds of being adherent (OR=0.741; 95%CI=0.551–0.995; p=0.046). The present study supports a steadily growing body of literature calling for more consideration and evidence to support a definition of PAP therapy adherence that is clinically meaningful.","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139624904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring knowledge gaps and research needs in respiratory therapy: a qualitative description study.","authors":"Marco Zaccagnini, Andrew West, Esther Khor, Shirley Quach, Mika L Nonoyama","doi":"10.29390/001c.91184","DOIUrl":"10.29390/001c.91184","url":null,"abstract":"<p><strong>Background: </strong>Respiratory therapists (RTs) are expected to stay updated on technology, treatments, research, and best practices to provide high-quality patient care. They must possess the skills to interpret, evaluate, and contribute to evidence-based practices. However, RTs often rely on research from other professions that may not fully address their specific needs, leading to insufficient guidance for their practice. Additionally, there has been no exploration of knowledge gaps and research needs from RTs' perspectives to enhance their practice and patient outcomes. The research questions guiding this study were: (<i>i</i>) what are the perceived practice-oriented knowledge gaps? and (<i>ii</i>) what are the necessary research priorities across the respiratory therapy profession according to experts in respiratory therapy?</p><p><strong>Methods: </strong>A qualitative description study was conducted using semi-structured focus groups with 40 expert RTs from seven areas of practice across Canada. Data was analyzed using qualitative content analysis.</p><p><strong>Results: </strong>We identified four major themes relating to what these experts perceive as the practice-oriented gaps and necessary research priorities across the respiratory therapy profession: 1) system-level impact of RTs, 2) optimizing respiratory therapy practices, 3) scholarship on the respiratory therapy profession and 4) respiratory therapy education.</p><p><strong>Discussion: </strong>The findings establish a fundamental understanding of the current gaps and the specific needs of RTs that require further investigation. Participants strongly emphasized the significance of research priorities that consider the breadth and depth of the respiratory therapy profession, which underscores the complex nature of respiratory therapy and its application in practice.</p><p><strong>Conclusion: </strong>The unique insights garnered from this study highlight the knowledge gaps and research needs specific to RTs. These findings pave the way for further exploration, discourse, and research aimed at understanding the specific contributions and requirements of RTs.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10769513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of noninvasive respiratory support on interstitial lung disease with acute respiratory failure: A systematic review and meta-analysis.","authors":"Natthawan Sanguanwong, Nattawat Jantarangsi, Jinjuta Ngeyvijit, Natthida Owattanapanich, Vorakamol Phoophiboon","doi":"10.29390/001c.89284","DOIUrl":"10.29390/001c.89284","url":null,"abstract":"<p><strong>Background: </strong>Primary studies have demonstrated the effectiveness of noninvasive respiratory supports, including noninvasive positive pressure ventilation (NIPPV) and high flow nasal cannula (HFNC), for improving oxygenation and ventilation in patients with interstitial lung diseases (ILDs) and acute respiratory failure (ARF). These studies have not been synthesized and are not included in current practice guidelines. This systematic review with meta-analysis synthesizes studies that compared the effectiveness of NIPPV, HFNC and conventional oxygen therapy (COT) for improving oxygenation and ventilation in ILD patients with ARF.</p><p><strong>Methods: </strong>MEDLINE, EMBASE and the Cochrane Library searches were conducted from inception to August 2023. An additional search of relevant primary literature and review articles was also performed. A random effects model was used to estimate the PF ratio (ratio of arterial oxygen partial pressure to fractional inspired oxygen), PaCO₂ (partial pressure of carbon dioxide), mortality, intubation rate and hospital length of stay.</p><p><strong>Results: </strong>Ten studies were included in the systematic review and meta-analysis. Noninvasive respiratory supports demonstrated a significant improvement in PF ratio compared to conventional oxygen therapy (COT); the mean difference was 55.92 (95% CI [18.85-92.99]; <i>p</i>=0.003). Compared to HFNC, there was a significant increase in PF ratio in NIPPV (mean difference 0.45; 95% CI [0.12-0.79]; <i>p</i>=0.008). There were no mortality and intubation rate benefits when comparing NIPPV and HFNC; the mean difference was 1.1; 95% CI [0.83-1.44]; <i>p</i>=0.51 and 1.86; 95% CI [0.42-8.33]; <i>p</i>=0.42, respectively. In addition, there was a significant decrease in hospital length of stay in HFNC compared to NIPPV (mean difference 9.27; 95% Cl [1.45 - 17.1]; <i>p</i>=0.02).</p><p><strong>Conclusions: </strong>Noninvasive respiratory supports might be an alternative modality in ILDs with ARF. NIPPV demonstrated a potential to improve the PF ratio compared to HFNC. There was no evidence to support the benefit of NIPPV or HFNC in terms of mortality and intubation rate.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"59 ","pages":"232-244"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}