Zhongguo quanke yixue (Sep 2022)
Summary of Best Evidence for the Management of Noninvasive Positive Pressure Ventilation in Adults with Obstructive Sleep Apnea Hypopnea Syndrome
Abstract
Background Noninvasive positive pressure ventilation (NPPV) is the most common treatment for obstructive sleep apnea hypopnea syndrome (OSAHS) , which can effectively improve the hypopnea condition. At present, there are various NPPV programs with no summary of the relevant best evidence in China. Objective To search and evaluate studies related to NPPV management in OSAHS patients, then summarize the best evidence, to inform clinical practice. Methods All evidence (including guideline, expert consensus, randomized controlled trial, evidence summary, systematic evaluation and meta-analysis) on the management of NPPV in patients with OSAHS was retrieved from databases and websites including BMJ Best Practice, Up To Date, Scottish Intercollegiate Guidelines Network, Guidelines International Network, National Institute for Health and Care Excellence, National Guideline Clearinghouse, Registered Nurses' Association of Ontario, New Zealand Guidelines Group, Chinese Guideline Network, the Joanna Briggs Institute Evidence-based Health Care Center, Cochrane Library, Web of Science, Embase, PubMed, Scopus, Wanfang Data, CNKI, VIP and American Academy of Sleep Medicine from inception to December, 2021. The methodological quality of the included literature was evaluated using corresponding quality evaluation criteria. The evidence was described and summarized using JBI levels of evidenceand and JBI grades of recommendation (2014) , then the recommended strength of the evidence is determined according to the FAME scale (feasibility, appropriateness, meaningfulness and effectiveness) . Results A total of 10 studies were included, including 6 guidelines, 2 expert consensuses, 1 Meta-analysis and 1 randomized controlled trial. Finally, 27 pieces of best evidence were summarized, involving 8 aspects: scope of application, duration of use, mode selection, pressure regulation, efficacy evaluation, nursing intervention, follow-up and alternative treatment. Conclusion We summarized the best evidence involving the above-mentioned 8 aspects for NPPV management in OSAHS patients, providing an evidence-based basis for the implementation of standardized NPPV treatment.
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