Effect of different noninvasive ventilation interfaces on the prevention of facial pressure injury: A network meta-analysis

Tingting Yang; Yuxia Ma; Xiaoli Chen; Qiuxia Yang; Juhong Pei; Ziyao Zhang; Xiaoling Qian; Yunyun Wang; Xiangping Fan; Lin Han

doi:10.1016/j.iccn.2023.103585

Effect of different noninvasive ventilation interfaces on the prevention of facial pressure injury: A network meta-analysis

Intensive Crit Care Nurs. 2024 Apr:81:103585. doi: 10.1016/j.iccn.2023.103585. Epub 2023 Nov 16.

Authors

Tingting Yang¹, Yuxia Ma¹, Xiaoli Chen², Qiuxia Yang³, Juhong Pei³, Ziyao Zhang⁴, Xiaoling Qian⁵, Yunyun Wang⁶, Xiangping Fan⁷, Lin Han⁸

Affiliations

¹ Evidence-based Nursing Center, School of Nursing, School of First Clinical Medical, Lanzhou University, Lanzhou, Gansu, China.
² Department of Pediatrics, Gansu Provincial Hospital, Lanzhou, Gansu, China.
³ School of First Clinical Medical, Lanzhou University, Lanzhou, Gansu, China.
⁴ School of Foreign Languages, Lanzhou University of Arts and Science, Lanzhou, Gansu, China.
⁵ Department of Neurology, Lanzhou University Second Hospital, Lanzhou, Gansu, China.
⁶ Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China.
⁷ Department of Nursing, The Third People's Hospital of Lanzhou, Lanzhou, Gansu, China.
⁸ Department of Nursing, Gansu Provincial Hospital, Lanzhou, Gansu, China. Electronic address: lzu-hanlin@hotmail.com.

PMID: 37977002
DOI: 10.1016/j.iccn.2023.103585

Abstract

Objective: To assess the effect of different noninvasive ventilation interfaces on preventing the facial pressure injury.

Methods: This network meta-analysis was conducted following the PRISMA reporting guidelines. Seven electronic databases were systematically searched for randomised controlled trials about the comparative effectiveness of different interfaces in preventing facial pressure injury with noninvasive ventilation in adults and newborns from inception to June 2023. The acronym of PICOS was used and the keywords as well as inclusion/exclusion criteria were determined. Study selection and data extraction were performed by two independent reviewers. The Cochrane risk of bias assessment tool was used to assess the methodological quality.

Results: A total of 78 randomised controlled trials involving 7,291 patients were included. The results of network meta-analysis showed that the effectiveness of the eight noninvasive ventilation interfaces on the prevention of facial pressure injury was in the order of: nasal cannula > full-face mask > rotation of nasal mask with nasal prongs > helmet > nasal mask > oronasal mask > nasal prongs > face mask. The use of full-face mask in adults and nasal cannula in newborns had the best effect on preventing the incidence of facial pressure injury.

Conclusions: The use of full-face mask in adults and nasal cannula in newborns had the most clinical advantage in preventing the incidence of facial pressure injury and were worthy promoting in clinical practice.

Implications for clinical practice: This study provides a certain theoretical basis for the selection of appropriate interface for patients with noninvasive ventilation. Clinical practitioners should choose the appropriate interfaces based on the patient's specific condition to reduce the incidence of facial pressure injury, enhance patient comfort, and improve the effectiveness of respiratory therapy.

Keywords: Network meta-analysis; Noninvasive ventilation; Pressure injury.

Publication types

Systematic Review
Meta-Analysis
Review

MeSH terms

Adult
Humans
Incidence
Infant, Newborn
Masks / adverse effects
Network Meta-Analysis
Noninvasive Ventilation* / adverse effects
Noninvasive Ventilation* / methods
Pressure Ulcer* / etiology
Pressure Ulcer* / prevention & control
Randomized Controlled Trials as Topic