What is the aim of this review?

The aim of this Cochrane review was to look at how the effects of non-invasive ventilation (NIV) compared to invasive ventilation in the treatment of respiratory failure in people with diseases affecting the nerves, muscles or the chest wall. The review set out to compare the two methods in terms of the effects on short-term survival, side effects, and the length of hospital stay.

What was studied in the review?

When someone has severe difficulty in breathing, they may need assistance from a machine (ventilator) which is able to move air in and out of the lungs. Invasive and non-invasive ventilation differ in how the air is delivered to the person. In invasive ventilation, air is delivered via a tube that is inserted into the windpipe through the mouth or sometimes the nose. In NIV, air is delivered through a sealed mask that can be placed over the mouth, nose or the whole face.

Invasive ventilation is the standard treatment used for people with neuromuscular diseases or chest wall disorders who are suffering from acute respiratory failure. However, NIV may offer some advantages such as being able to talk and swallow, and may have fewer risks.

Key Messages

The review authors collected and assessed all the relevant studies to answer this question but did not identify any trials that met the standards needed to be included in the review.

So far, there is no evidence from randomised studies either for or against the routine use of NIV instead of invasive ventilation in people with acute respiratory failure caused by either neuromuscular disease or a chest wall disorder.

However, some evidence from observational studies suggests that NIV should be trialled in all patients except for those with bulbar dysfunction.

How up to date is this review?

The evidence is up to date to 11 September 2017.