A systematic review and meta-analysis of different mask ventilation schemes on management of general anesthesia in patients with respiratory failure.

Abstract

Difficulty in mask ventilation is one of the more dangerous factors in general anesthesia. The traditional mask has some problems, such as air leakage and facial skin compression injury. The head cover is a new interactive non-invasive ventilation (NIV) model. NIV studies comparing hoods and masks have all been single-center and small-sample randomized trials, and extensive clinical studies are lacking. We conducted a computerized search in the databases of PubMed, Embase, Medline, Chinese Biomedical Literature (CBM), and others for randomized controlled trials (RCTs) on the effect of hoods and masks on patients with respiratory failure published since their establishment to March 2021. The quality of the included literature was assessed using the Cochrane Systematic Review Manual, and the data was analyzed using Review Manager 5.3 to assess the risk of bias. A total of 9 articles were included, involving 462 patients, with 233 patients in the hood group and 229 patients in the face mask group. The results of meta-analysis showed the comparative endotracheal intubation rate of the hood group and the mask group [odds ratio (OR) =0.26; 95% confidence interval (CI): 0.14 to 0.47; Z=4.48; P<0.00001], the complications rate (OR =0.54; 95% CI: 0.31 to 0.97; Z=2.08; P=0.04) was statistically considerable, although there was no considerable difference in in-hospital mortality (OR =0.56; 95% CI: 0.28 to 1.14; Z=1.59; P=0.11). NIV with a hood can reduce the rate of endotracheal intubation and the incidence of related complications in patients with acute respiratory failure (ARF), which has considerable advantages in contrast to the traditional mask.