Effect of Intensity of Home Noninvasive Ventilation in Individuals With Neuromuscular and Chest Wall Disorders: A Systematic Review and Meta-Analysis of Individual Participant Data

Mathieu Delorme; Antoine Leotard; Marius Lebret; Claire Lefeuvre; Anda Hazenberg; Mercedes Pallero; Annabel H Nickol; Liam M Hannan; Matthias Boentert; Aycan Yüksel; Wolfram Windisch; Mark E Howard; Nicholas Hart; Peter J Wijkstra; Hélène Prigent; Jean-Louis Pepin; Frederic Lofaso; Charles Khouri; Jean-Christian Borel

doi:10.1016/j.arbres.2023.05.002

Effect of Intensity of Home Noninvasive Ventilation in Individuals With Neuromuscular and Chest Wall Disorders: A Systematic Review and Meta-Analysis of Individual Participant Data

Mathieu Delorme, Antoine Leotard, Marius Lebret, Claire Lefeuvre, Anda Hazenberg, Mercedes Pallero, Annabel H Nickol, Liam M Hannan, Matthias Boentert, Aycan Yüksel, Wolfram Windisch, Mark E Howard, Nicholas Hart, Peter J Wijkstra, Hélène Prigent, Jean-Louis Pepin, Frederic Lofaso, Charles Khouri, Jean-Christian Borel^*

^*Corresponding author for this work

Groningen Research Institute for Asthma and COPD (GRIAC)

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

INTRODUCTION: Home noninvasive ventilation (NIV), targeting a reduction of carbon dioxide with a combination of sufficient inspiratory support and backup-rate improves outcomes in patients with chronic obstructive pulmonary disease. The aim of this systematic review with individual participant data (IPD) meta-analysis was to evaluate the effects of intensity of home NIV on respiratory outcomes in individuals with slowly progressive neuromuscular (NMD) or chest-wall disorders (CWD).

METHODS: Controlled, non-controlled and cohort studies indexed between January-2000 and December-2020 were sought from Medline, Embase and the Cochrane Central Register. Outcomes were diurnal PaCO 2, PaO 2, daily NIV usage, and interface type (PROSPERO-CRD 42021245121). NIV intensity was defined according to the Z-score of the product of pressure support (or tidal volume) and backup-rate.

RESULTS: 16 eligible studies were identified; we obtained IPD for 7 studies (176 participants: 113-NMD; 63-CWD). The reduction in PaCO 2 was greater with higher baseline PaCO 2. NIV intensity per se was not associated with improved PaCO 2 except in individuals with CWD and the most severe baseline hypercapnia. Similar results were found for PaO 2. Daily NIV usage was associated with improvement in gas exchange but not with NIV intensity. No association between NIV intensity and interface type was found.

CONCLUSION: Following home NIV initiation in NMD or CWD patients, no relationship was observed between NIV intensity and PaCO 2, except in individuals with the most severe CWD. The amount of daily NIV usage, rather than intensity, is key to improving hypoventilation in this population during the first few months after introduction of therapy.

Original language	English
Pages (from-to)	488-496
Number of pages	9
Journal	Archivos de bronconeumologia
Volume	59
Issue number	8
Early online date	11-May-2023
DOIs	https://doi.org/10.1016/j.arbres.2023.05.002
Publication status	Published - Aug-2023

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Delorme, M., Leotard, A., Lebret, M., Lefeuvre, C., Hazenberg, A., Pallero, M., Nickol, A. H., Hannan, L. M., Boentert, M., Yüksel, A., Windisch, W., Howard, M. E., Hart, N., Wijkstra, P. J., Prigent, H., Pepin, J.-L., Lofaso, F., Khouri, C., & Borel, J.-C. (2023). Effect of Intensity of Home Noninvasive Ventilation in Individuals With Neuromuscular and Chest Wall Disorders: A Systematic Review and Meta-Analysis of Individual Participant Data. Archivos de bronconeumologia, 59(8), 488-496. https://doi.org/10.1016/j.arbres.2023.05.002

@article{3e4fa9f1eb1f4440996364fa16044c80,

title = "Effect of Intensity of Home Noninvasive Ventilation in Individuals With Neuromuscular and Chest Wall Disorders: A Systematic Review and Meta-Analysis of Individual Participant Data",

abstract = "INTRODUCTION: Home noninvasive ventilation (NIV), targeting a reduction of carbon dioxide with a combination of sufficient inspiratory support and backup-rate improves outcomes in patients with chronic obstructive pulmonary disease. The aim of this systematic review with individual participant data (IPD) meta-analysis was to evaluate the effects of intensity of home NIV on respiratory outcomes in individuals with slowly progressive neuromuscular (NMD) or chest-wall disorders (CWD).METHODS: Controlled, non-controlled and cohort studies indexed between January-2000 and December-2020 were sought from Medline, Embase and the Cochrane Central Register. Outcomes were diurnal PaCO 2, PaO 2, daily NIV usage, and interface type (PROSPERO-CRD 42021245121). NIV intensity was defined according to the Z-score of the product of pressure support (or tidal volume) and backup-rate. RESULTS: 16 eligible studies were identified; we obtained IPD for 7 studies (176 participants: 113-NMD; 63-CWD). The reduction in PaCO 2 was greater with higher baseline PaCO 2. NIV intensity per se was not associated with improved PaCO 2 except in individuals with CWD and the most severe baseline hypercapnia. Similar results were found for PaO 2. Daily NIV usage was associated with improvement in gas exchange but not with NIV intensity. No association between NIV intensity and interface type was found. CONCLUSION: Following home NIV initiation in NMD or CWD patients, no relationship was observed between NIV intensity and PaCO 2, except in individuals with the most severe CWD. The amount of daily NIV usage, rather than intensity, is key to improving hypoventilation in this population during the first few months after introduction of therapy. ",

author = "Mathieu Delorme and Antoine Leotard and Marius Lebret and Claire Lefeuvre and Anda Hazenberg and Mercedes Pallero and Nickol, {Annabel H} and Hannan, {Liam M} and Matthias Boentert and Aycan Y{\"u}ksel and Wolfram Windisch and Howard, {Mark E} and Nicholas Hart and Wijkstra, {Peter J} and H{\'e}l{\`e}ne Prigent and Jean-Louis Pepin and Frederic Lofaso and Charles Khouri and Jean-Christian Borel",

year = "2023",

month = aug,

doi = "10.1016/j.arbres.2023.05.002",

language = "English",

volume = "59",

pages = "488--496",

journal = "Archivos de bronconeumologia",

issn = "0300-2896",

publisher = "Elsevier",

number = "8",

}

Delorme, M, Leotard, A, Lebret, M, Lefeuvre, C, Hazenberg, A, Pallero, M, Nickol, AH, Hannan, LM, Boentert, M, Yüksel, A, Windisch, W, Howard, ME, Hart, N, Wijkstra, PJ, Prigent, H, Pepin, J-L, Lofaso, F, Khouri, C & Borel, J-C 2023, 'Effect of Intensity of Home Noninvasive Ventilation in Individuals With Neuromuscular and Chest Wall Disorders: A Systematic Review and Meta-Analysis of Individual Participant Data', Archivos de bronconeumologia, vol. 59, no. 8, pp. 488-496. https://doi.org/10.1016/j.arbres.2023.05.002

Effect of Intensity of Home Noninvasive Ventilation in Individuals With Neuromuscular and Chest Wall Disorders: A Systematic Review and Meta-Analysis of Individual Participant Data. / Delorme, Mathieu; Leotard, Antoine; Lebret, Marius et al.
In: Archivos de bronconeumologia, Vol. 59, No. 8, 08.2023, p. 488-496.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Effect of Intensity of Home Noninvasive Ventilation in Individuals With Neuromuscular and Chest Wall Disorders

T2 - A Systematic Review and Meta-Analysis of Individual Participant Data

AU - Delorme, Mathieu

AU - Leotard, Antoine

AU - Lebret, Marius

AU - Lefeuvre, Claire

AU - Hazenberg, Anda

AU - Pallero, Mercedes

AU - Nickol, Annabel H

AU - Hannan, Liam M

AU - Boentert, Matthias

AU - Yüksel, Aycan

AU - Windisch, Wolfram

AU - Howard, Mark E

AU - Hart, Nicholas

AU - Wijkstra, Peter J

AU - Prigent, Hélène

AU - Pepin, Jean-Louis

AU - Lofaso, Frederic

AU - Khouri, Charles

AU - Borel, Jean-Christian

PY - 2023/8

Y1 - 2023/8

N2 - INTRODUCTION: Home noninvasive ventilation (NIV), targeting a reduction of carbon dioxide with a combination of sufficient inspiratory support and backup-rate improves outcomes in patients with chronic obstructive pulmonary disease. The aim of this systematic review with individual participant data (IPD) meta-analysis was to evaluate the effects of intensity of home NIV on respiratory outcomes in individuals with slowly progressive neuromuscular (NMD) or chest-wall disorders (CWD).METHODS: Controlled, non-controlled and cohort studies indexed between January-2000 and December-2020 were sought from Medline, Embase and the Cochrane Central Register. Outcomes were diurnal PaCO 2, PaO 2, daily NIV usage, and interface type (PROSPERO-CRD 42021245121). NIV intensity was defined according to the Z-score of the product of pressure support (or tidal volume) and backup-rate. RESULTS: 16 eligible studies were identified; we obtained IPD for 7 studies (176 participants: 113-NMD; 63-CWD). The reduction in PaCO 2 was greater with higher baseline PaCO 2. NIV intensity per se was not associated with improved PaCO 2 except in individuals with CWD and the most severe baseline hypercapnia. Similar results were found for PaO 2. Daily NIV usage was associated with improvement in gas exchange but not with NIV intensity. No association between NIV intensity and interface type was found. CONCLUSION: Following home NIV initiation in NMD or CWD patients, no relationship was observed between NIV intensity and PaCO 2, except in individuals with the most severe CWD. The amount of daily NIV usage, rather than intensity, is key to improving hypoventilation in this population during the first few months after introduction of therapy.

AB - INTRODUCTION: Home noninvasive ventilation (NIV), targeting a reduction of carbon dioxide with a combination of sufficient inspiratory support and backup-rate improves outcomes in patients with chronic obstructive pulmonary disease. The aim of this systematic review with individual participant data (IPD) meta-analysis was to evaluate the effects of intensity of home NIV on respiratory outcomes in individuals with slowly progressive neuromuscular (NMD) or chest-wall disorders (CWD).METHODS: Controlled, non-controlled and cohort studies indexed between January-2000 and December-2020 were sought from Medline, Embase and the Cochrane Central Register. Outcomes were diurnal PaCO 2, PaO 2, daily NIV usage, and interface type (PROSPERO-CRD 42021245121). NIV intensity was defined according to the Z-score of the product of pressure support (or tidal volume) and backup-rate. RESULTS: 16 eligible studies were identified; we obtained IPD for 7 studies (176 participants: 113-NMD; 63-CWD). The reduction in PaCO 2 was greater with higher baseline PaCO 2. NIV intensity per se was not associated with improved PaCO 2 except in individuals with CWD and the most severe baseline hypercapnia. Similar results were found for PaO 2. Daily NIV usage was associated with improvement in gas exchange but not with NIV intensity. No association between NIV intensity and interface type was found. CONCLUSION: Following home NIV initiation in NMD or CWD patients, no relationship was observed between NIV intensity and PaCO 2, except in individuals with the most severe CWD. The amount of daily NIV usage, rather than intensity, is key to improving hypoventilation in this population during the first few months after introduction of therapy.

U2 - 10.1016/j.arbres.2023.05.002

DO - 10.1016/j.arbres.2023.05.002

M3 - Article

C2 - 37217384

SN - 0300-2896

VL - 59

SP - 488

EP - 496

JO - Archivos de bronconeumologia

JF - Archivos de bronconeumologia

IS - 8

ER -

Effect of Intensity of Home Noninvasive Ventilation in Individuals With Neuromuscular and Chest Wall Disorders: A Systematic Review and Meta-Analysis of Individual Participant Data

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