Supplemental table 1: Characteristics and outcomes of the analysed studies

Transcription

1 SUPPLEMENTAL DIGITAL CONTENT List of documents Supplemental References Supplemental table 1: Characteristics and outcomes of the analysed studies Supplemental table 2. Sensitivity analyses Supplemental figure 1. Flow diagram for the selection of articles Supplemental figure 2. Forest plot of the effect of NIV treatment on mortality Supplemental figure 3. Forest plot on the effect of different types of preventive NIV on mortality Supplemental figure 4. Forest plot of on the effect of different types of NIV used to facilitate an earlier extubation on mortality at the longest follow up available (RR=Risk Ratio) Supplemental figure 5. Forest plot on the effect of NIV treatment in different settings on hospital mortality (RR= Risk Ratio) Supplemental figure 6. Forest plot on the effect of NIV used as a preventive treatment on hospital mortality (RR=Risk Ratio) Supplemental figure 7. Forest plot on the effect of NIV used to facilitate an earlier extubation on hospital mortality (RR=Risk Ratio) Supplemental figure 8. Funnel plot for the risk of hospital mortality Supplemental figure 9. Funnel plot for the risk of hospital mortality for NIV treatment Supplemental figure 10. Funnel plot for the risk of mortality at the longest follow-up available 1

2 Supplemental figure 11. Funnel plot for the risk of mortality at longest follow-up available for NIV treatment Supplemental figure 12. Funnel plot for the risk of mortality at longest follow-up available, for NIV used as preventive treatment Supplemental figure 13.Univariate meta-regression of follow-up length against log-risk mortality Supplemental figure 14.Univariate metaregression of publication year on log-risk mortality Supplemental figure 15. Cumulative meta-analysis for the risk of mortality Supplemental References: all included articles 1. Al Jaaly E, Fiorentino F, Reeves BC, et al: Effect of adding postoperative noninvasive ventilation to usual care to prevent pulmonary complications in patients undergoing coronary artery bypass grafting:a randomized controlled trial. J ThoracCardiovascSurg 2013; 146: Angus RM, Ahmed AA, Fenwick LJ, et al: Comparison of the acute effects on gas exchange of nasal ventilation and doxapram in exacerbations of chronic obstructive pulmonary disease. Thorax 1996; 51: Antonelli M, Conti G, Bufi M, et al:noninvasive ventilation for treatment of acute respiratory failure in patients undergoing solid organ transplantation:a randomized trial. JAMA 2000; 283: Antonelli M, Conti G, Rocco M, et al: A comparison of noninvasive positive-pressure ventilation and conventional mechanical ventilation in patients with acute respiratory failure. N Engl J Med 1998; 339:

3 5. Antonelli M, Conti G, Rocco M, et al: Noninvasive positive-pressure ventilation vs. conventional oxygen supplementation in hypoxemic patients undergoing diagnostic bronchoscopy. Chest 2002; 121: Auriant I, Jallot A, Hervé P, et al: Noninvasive ventilation reduces mortality in acute respiratory failure following lung resection. Am J RespirCrit Care Med 2001; 164: Barbagallo M, Ortu A, Spadini E, et al: Prophylactic use of helmet CPAP after pulmonary lobectomy:a prospective randomized controlled study. Respir Care 2012; 57: Barbé F, Togores B, Rubí M, et al: Noninvasive ventilatory support does not facilitate recovery from acute respiratory failure in chronic obstructive pulmonary disease. EurRespir J 1996; 9: Böhner H, Kindgen-Milles D, Grust A, et al: Prophylactic nasal continuous positive airway pressure after major vascular surgery: results of a prospective randomized trial. Langenbecks Arch SurgDtschGesFürChir 2002; 387: Brochard L, Mancebo J, Wysocki M, et al: Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N Engl J Med 1995; 333: Celikel T, Sungur M, Ceyhan B, et al: Comparison of noninvasive positive pressure ventilation with standard medical therapy in hypercapnic acute respiratory failure. Chest 1998; 114: Collaborating Research Group for Noninvasive Mechanical Ventilation of Chinese Respiratory Society: infection control window in treatment of severe respiratory failure of chronic obstructive pulmonary diseases: a prospective, randomized controlled, multi-centred study. Chin Med J 2005; 118: Collaborative Research Group of Noninvasive Mechanical Ventilation for Chronic Obstructive Disease: Early use of non-invasive positive pressure ventilation for acute exacerbations of chronic obstructive pulmonary disease: a multicentre randomized controlled trial. Chin Med J 2005; 118:

4 14. Confalonieri M, Potena A, Carbone G, et al: Acute respiratory failure in patients with severe community-acquired pneumonia. A prospective randomized evaluation of noninvasive ventilation. Am J RespirCrit Care Med 1999; 160: Conti G, Antonelli M, Navalesi P, et al: Noninvasive vs. conventional mechanical ventilation in patients with chronic obstructive pulmonary disease after failure of medical treatment in the ward: a randomized trial. Intensive Care Med 2002; 28: Cosentini R, Brambilla AM, Aliberti S, et al: Helmet continuous positive airway pressure vs oxygen therapy to improve oxygenation in community-acquired pneumonia: a randomized, controlled trial. Chest 2010; 138: Crane SD, Elliott MW, Gilligan P, et al: Randomised controlled comparison of continuous positive airways pressure, bilevel non-invasive ventilation, and standard treatment in emergency department patients with acute cardiogenic pulmonary oedema. Emerg Med J 2004; 21: Delclaux C, L Her E, Alberti C, et al: Treatment of acute hypoxemic nonhypercapnic respiratory insufficiency with continuous positive airway pressure delivered by a face mask:a randomized controlled trial. JAMA 2000; 284: Dhamija A, Tyagi P, Caroli R, et al: Noninvasive ventilation in mild to moderate cases of respiratory failure due to acute exacerbation of chronic obstructive pulmonary disease. Saudi Med J 2005; 26: Dikensoy O, Ikidag B, Filiz A, et al: Comparison of non-invasive ventilation and standard medical therapy in acute hypercapnic respiratory failure:a randomised controlled study at a tertiary health centre in SE Turkey. Int J ClinPract 2002; 56: Ducros L, Logeart D, Vicaut E, et al: CPAP for acute cardiogenic pulmonary oedema from out-of-hospital to cardiac intensive care unit:a randomisedmulticentre study. Intensive Care Med 2011; 37:

5 22. Esteban A, Frutos-Vivar F, Ferguson ND, et al: Noninvasive positive-pressure ventilation for respiratory failure after extubation. N Engl J Med 2004; 350: FagevikOlsén M, Wennberg E, Johnsson E, et al: Randomized clinical study of the prevention of pulmonary complications after thoracoabdominal resection by two different breathing techniques. Br J Surg 2002; 89: Ferrer M, Esquinas A, Arancibia F, et al: Noninvasive ventilation during persistent weaning failure:a randomized controlled trial. Am J Respir Crit Care Med 2003; 168: Ferrer M, Esquinas A, Leon M, et al: Noninvasive ventilation in severe hypoxemic respiratory failure:a randomized clinical trial. Am J Respir Crit Care Med 2003; 168: Ferrer M, Sellarés J, Valencia M, et al: Non-invasive ventilation after extubation in hypercapnic patients with chronic respiratory disorders: randomised controlled trial. Lancet 2009; 374: Ferrer M, Valencia M, Nicolas JM, et al: Early noninvasive ventilation averts extubation failure in patients at risk:a randomized trial. Am J Respir Crit Care Med 2006; 173: Girault C, Daudenthun I, Chevron V, et al: Noninvasive ventilation as a systematic extubation and weaning technique in acute-on-chronic respiratory failure: a prospective, randomized controlled study. Am J Respir Crit Care Med 1999; 160: Frontin P, Bounes V, Houzé-Cerfon CH, et al: Continuous positive airway pressure for cardiogenic pulmonary edema:a randomized study. Am J Emerg Med 2011; 29: Girault C, Bubenheim M, Abroug F, et al: Noninvasive ventilation and weaning in patients with chronic hypercapnic respiratory failure: a randomized multicenter trial. Am J Respir Crit Care Med 2011; 184: Gray A, Goodacre S, Newby DE, et al: Noninvasive ventilation in acute cardiogenic pulmonary edema. N Engl J Med 2008; 359:

6 32. Gunduz M, Unlugenc H, Ozalevli M, et al: A comparative study of continuous positive airway pressure (CPAP) and intermittent positive pressure ventilation (IPPV) in patients with flail chest. Emerg Med J 2005; 22: Gupta D, Nath A, Agarwal R, et al: A prospective randomized controlled trial on the efficacy of noninvasive ventilation in severe acute asthma. Respir Care 2010; 55: Hernandez G, Fernandez R, Lopez-Reina P, et al: Noninvasive ventilation reduces intubation in chest trauma-related hypoxemia: a randomized clinical trial. Chest 2010; 137: Hilbert G, Gruson D, Vargas F, et al: Noninvasive ventilation in immunosuppressed patients with pulmonary infiltrates, fever, and acute respiratory failure. N Engl J Med 2001; 344: Honrubia T, GarcíaLópez FJ, Franco N, et al: Noninvasive vs conventional mechanical ventilation in acute respiratory failure:a multicenter, randomized controlled trial. Chest 2005; 128: Keenan SP, Powers C, McCormack DG, et al: Noninvasive positive-pressure ventilation for postextubation respiratory distress:a randomized controlled trial. JAMA 2002; 287: Keenan SP, Powers CE, McCormack DG: Noninvasive positive-pressure ventilation in patients with milder chronic obstructive pulmonary disease exacerbations: a randomized controlled trial. Respir Care 2005; 50: Kelly CA, Newby DE, McDonagh TA, et al: Randomised controlled trial of continuous positive airway pressure and standard oxygen therapy in acute pulmonary oedema; effects on plasma brain natriuretic peptide concentrations. Eur Heart J 2002; 23: Khilnani GC, Saikia N, Banga A, et al: Non-invasive ventilation for acute exacerbation of COPD with very high PaCO(2): A randomized controlled trial. Lung India Off Organ Indian Chest Soc 2010; 27:

7 41. Kramer N, Meyer TJ, Meharg J, et al: Randomized, prospective trial of noninvasive positive pressure ventilation in acute respiratory failure. Am J RespirCrit Care Med 1995; 151: Levitt MA: A prospective, randomized trial of BiPAP in severe acute congestive heart failure. J Emerg Med 2001; 21: L Her E, Duquesne F, Girou E, et al: Noninvasive continuous positive airway pressure in elderly cardiogenic pulmonary edema patients. Intensive Care Med 2004; 30: Lin M, Yang YF, Chiang HT, et al: Reappraisal of continuous positive airway pressure therapy in acute cardiogenic pulmonary edema. Short-term results and long-term follow-up. Chest 1995; 107: Lorut C, Lefebvre A, Planquette B, et al: Early postoperative prophylactic noninvasive ventilation after major lung resection in COPD patients: a randomized controlled trial. Intensive Care Med 2013; 40: Martin TJ, Hovis JD, Costantino JP, et al: A randomized, prospective evaluation of noninvasive ventilation for acute respiratory failure. Am J Respir Crit Care Med 2000; 161: Masip J, Betbesé AJ, Páez J, et al: Non-invasive pressure support ventilation versus conventional oxygen therapy in acute cardiogenic pulmonary oedema: a randomised trial. Lancet 2000; 356: Nava S, Ambrosino N, Clini E, et al: Noninvasive mechanical ventilation in the weaning of patients with respiratory failure due to chronic obstructive pulmonary disease. A randomized, controlled trial. Ann Intern Med 1998; 128: Nava S, Carbone G, DiBattista N, et al: Noninvasive ventilation in cardiogenic pulmonary edema:a multicenter randomized trial. Am J Respir Crit Care Med 2003; 168: Nava S, Grassi M, Fanfulla F, et al: Non-invasive ventilation in elderly patients with acute hypercapnic respiratory failure:a randomised controlled trial. Age Ageing 2011; 40:

8 51. Nava S, Gregoretti C, Fanfulla F, et al: Noninvasive ventilation to prevent respiratory failure after extubation in high-risk patients. Crit Care Med 2005; 33: Ornico SR, Lobo SM, Sanches HS, et al: Noninvasive ventilation immediately after extubation improves weaning outcome after acute respiratory failure: a randomized controlled trial. Crit Care 2013; 17:R Park M, Lorenzi-Filho G, Feltrim MI, et al: Oxygen therapy, continuous positive airway pressure, or noninvasive bilevel positive pressure ventilation in the treatment of acute cardiogenic pulmonary edema. Arq Bras Cardiol 2001; 76: Park M, Sangean MC, Volpe Mde S, et al: Randomized, prospective trial of oxygen, continuous positive airway pressure, and bilevel positive airway pressure by face mask in acute cardiogenic pulmonary edema. Crit Care Med 2004; 32: Pastaka C, Kostikas K, Karetsi E,et al: Non-invasive ventilation in chronic hypercapnic COPD patients with exacerbation and a ph of 7.35 or higher. Eur J Intern Med 2007; 18: Perrin C, Jullien V, Vénissac N, et al: Prophylactic use of noninvasive ventilation in patients undergoing lung resectional surgery. Respir Med 2007; 101: Plant PK, Owen JL, Elliott M: Early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease on general respiratory wards: a multicentrerandomised controlled trial. Lancet 2000; 355: Roessler MS, Schmid DS, Michels P, et al: Early out-of-hospital non-invasive ventilation is superior to standard medical treatment in patients with acute respiratory failure: a pilot study. Emerg Med J 2012; 29: Schmidbauer W, Ahlers O, Spies C, et al: Early prehospital use of non-invasive ventilation improves acute respiratory failure in acute exacerbation of chronic obstructive pulmonary disease. Emerg Med J 2011; 28:

9 60. Sharon A, Shpirer I, Kaluski E, et al: High-dose intravenous isosorbide-dinitrate is safer and better than Bi-PAP ventilation combined with conventional treatment for severe pulmonary edema. J Am Coll Cardiol 2000; 36: Soma T, Hino M, Kida K, et al: A prospective and randomized study for improvement of acute asthma by non-invasive positive pressure ventilation (NPPV). Intern Med 2008; 47: Soroksky A, Stav D, Shpirer I. A pilot prospective, randomized, placebo-controlled trial of bilevel positive airway pressure in acute asthmatic attack. Chest 2003; 123: Squadrone V, Coha M, Cerutti E, et al: Continuous positive airway pressure for treatment of postoperative hypoxemia:a randomized controlled trial. JAMA 2005; 293: Squadrone V, Massaia M, Bruno B, et al: Early CPAP prevents evolution of acute lung injury in patients with hematologic malignancy. Intensive Care Med 2010; 36: Su C-L, Chiang L-L, Yang S-H, et al: Preventive use of noninvasive ventilation after extubation:a prospective, multicenter randomized controlled trial. Respir Care 2012; 57: Takeda S, Nejima J, Takano T, et al: Effect of nasal continuous positive airway pressure on pulmonary edema complicating acute myocardial infarction. Jpn Circ J 1998; 62: Takeda S, Takano T, Ogawa R: The effect of nasal continuous positive airway pressure on plasma endothelin-1 concentrations in patients with severe cardiogenic pulmonary edema. AnesthAnalg 1997; 84: Thompson J, Petrie DA, Ackroyd-Stolarz S, et al: Out-of-hospital continuous positive airway pressure ventilation versus usual care in acute respiratory failure: a randomized controlled trial. Ann Emerg Med 2008; 52: Thys F, Roeseler J, Reynaert M, et al: Noninvasive ventilation for acute respiratory failure:a prospective randomised placebo-controlled trial. EurRespir J; 20:

10 70. Trevisan CE, Vieira SR, Research Group in Mechanical Ventilation Weaning: Noninvasive mechanical ventilation may be useful in treating patients who fail weaning from invasive mechanical ventilation:a randomized clinical trial. Crit Care 2008; 12:R Vaschetto R, Turucz E, Dellapiazza F, et al: Noninvasive ventilation after early extubation in patients recovering from hypoxemic acute respiratory failure: a single-centre feasibility study. Intensive Care Med 2012; 38: Weitz G, Struck J, Zonak A, et al: Prehospital noninvasive pressure support ventilation for acute cardiogenic pulmonary edema. Eur J Emerg Med 2007; 14: Wermke M, Schiemanck S, Höffken G, et al: Respiratory failure in patients undergoing allogeneic hematopoietic SCT--a randomized trial on early non-invasive ventilation based on standard care hematology wards. Bone Marrow Transplant 2012; 47: Wong DT, Adly E, Ip HYV, et al: A comparison between the BoussignacTM continuous positive airway pressure mask and the venturi mask in terms of improvement in the PaO2/F(I)O2 ratio in morbidly obese patients undergoing bariatric surgery: a randomized controlled trial. Can J Anaesth 2011; 58: Wood KA, Lewis L, Von Harz B, et al: The use of noninvasive positive pressure ventilation in the emergency department:results of a randomized clinical trial. Chest 1998; 113: Wysocki M, Tric L, Wolff MA, et al: Noninvasive pressure support ventilation in patients with acute respiratory failure. A randomized comparison with conventional therapy. Chest 1995; 107: Zhan Q, Sun B, Liang L, et al: Early use of noninvasive positive pressure ventilation for acute lung injury:a multicenter randomized controlled trial. Crit Care Med 2012; 40: Zoremba M, Kalmus G, Begemann D, et al: Short term non-invasive ventilation postsurgery improves arterial blood-gases in obese subjects compared to supplemental oxygen delivery - a randomized controlled trial. BMC Anesthesiol 2011; 11:10 10

11 SUPPLEMENTAL TABLES Supplemental table 1: Characteristics and outcomes of the analysed studies First author Year Etiology Comparato r CPAP or NPPV Settin g Crossov er a yes/no Numbe r of patients in NIV group Numbe r of patients in control group Hospita l mortalit y - NIV Hospita l mortalit y - control Longest available follow up Mortality at longest available follow up - NIV Mortality at longest available follow up - control TREATMENT Angus RM [supplemental ref 2] 1996 Barbè F [supplemental ref 8] 1996 Brochard L [supplemental ref 10] 1995 Çelikel T [supplemental ref 11] 1998 Collaborative Research Group Of Non Invasive Mechanical Ventilation For Chronic Obstructive Disease [supplemental ref 13] 2005 Conti G [supplemental ref 15] 2002 Dhamija A [supplemental ref 19] 2005 Dikensoy O [supplemental ref 20] 2002 Keenan SP [supplemental ref 38] 2005 Khilnani GC [supplemental ref 40] 2010 Nava S [supplemental ref 50] 2011 Pastaka C [supplemental ref 55] 2007 COPD exacerbation COPD exacerbation COPD exacerbation COPD exacerbation COPD exacerbation COPD exacerbation COPD exacerbation COPD exacerbation COPD exacerbation COPD exacerbation COPD exacerbation COPD exacerbation Oxygen + Doxapram NPPV NR Yes 9 8 NR NR ICU 0 3 Oxygen NPPV Ward No Hospital 0 0 Oxygen NPPV ICU No Hospital 4 12 Oxygen NPPV ICU Yes Hospital 0 1 Oxygen NPPV Ward Yes Hospital 7 12 ETT NPPV ICU Yes year 6 12 Oxygen NPPV ED No Hospital 0 1 Oxygen NPPV Ward No Hospital 1 2 Oxygen NPPV Ward Yes Hospital 1 2 Oxygen NPPV ICU No Hospital 3 2 Oxygen NPPV Ward Yes year Oxygen NPPV Ward No Hospital

12 Plant PK [supplemental ref 57] 2000 COPD exacerbation Oxygen NPPV Ward Yes Hospital Gupta D [supplemental ref 33] 2010 Asthma Oxygen NPPV ICU Yes NR NR ICU 0 0 Soma T [supplemental ref 61] 2008 Asthma Oxygen NPPV ED No Hospital 0 0 Sorokski A [supplemental ref 62] 2003 Asthma Oxygen NPPV ED No Hospital 0 0 Crane S [supplemental ref 17] 2004 Gray A [supplemental ref 31] 2008 Kelly Ca [supplemental ref 39] 2002 L'Her E [supplemental ref 43] 2004 Lin M [supplemental ref 44] 1995 Levitt MA [supplemental ref 42] 2001 Masip J [supplemental ref 47] 2000 Nava S [supplemental ref 49] 2003 Park M [supplemental ref 53] 2001 Park M [supplemental ref 54] 2004 Sharon A [supplemental ref 60] 2000 Takeda S [supplemental ref 67] 1997 Takeda S [supplemental ref 66] 1998 Ducros L [supplemental ref 21] 2011 Frontin P [supplemental ref 29] 2011 Oxygen both ED No Hospital 5 6 Oxygen both ED No NR NR 30 days Oxygen CPAP ED No Hospital 2 7 Oxygen CPAP ED Yes Hospital Oxygen CPAP ED No year Oxygen NPPV ED No Hospital 3 3 Oxygen NPPV ICU No Hospital 0 2 Oxygen NPPV ED No Hospital 6 9 Oxygen both ED No Hospital 1 0 Oxygen both ED No Hospital 3 6 Oxygen + high dose isosorbide NPPV ED No Hospital 2 0 Oxygen CPAP ICU No NR NR ICU 1 3 Oxygen CPAP ICU No Hospital 1 7 Oxygen Oxygen CPAP CPAP Out of hospit al Out of hospit al Yes Hospital 8 9 No NR NR 30 days

13 Schmidbauer W [supplemental ref 59] 2011 Weitz G [supplemental ref 72] 2007 Oxygen Oxygen NPPV NPPV Out of hospit al Out of hospit al No Hospital 0 0 No Hospital 1 1 Confalonieri M [supplemental ref 14] 1999 ARF Oxygen NPPV ICU Yes days 7 10 Cosentini R [supplemental ref 16] 2010 ARF Oxygen CPAP ED No Hospital 0 0 Delclaux C [supplemental ref 18] 2000 ARF Oxygen CPAP ICU Yes Hospital Ferrer M [supplemental ref 25] 2003 ARF Oxygen NPPV ICU Yes NR NR 90 days Hernandez G [supplemental ref 14] 2010 ARF Oxygen NPPV ICU No Hospital 1 1 Hilbert G [supplemental ref 35] 2001 ARF Oxygen NPPV ICU No Hospital Kramer N [supplemental ref 41] 1995 ARF Oxygen NPPV ICU Yes Hospital 1 2 Martin TJ [supplemental ref 46] 2000 ARF Oxygen NPPV ICU Yes NR NR ICU 5 10 Roessler MS [supplemental ref 59] 2012 ARF Oxygen CPAP Out of hospit al Yes NR NR 90 days 1 3 Squadrone V [supplemental ref 64] 2010 ARF Oxygen CPAP Ward Yes Hospital 3 15 Thompson J [supplemental ref 68] 2008 ARF Oxygen CPAP Out of hospit al No Hospital 5 12 Thys F [supplemental ref 69] 2002 ARF Oxygen NPPV ED Yes Hospital 2 1 Wermke M [supplemental ref 73] 2012 ARF Oxygen NPPV Ward Yes NR NR 100 days Wood KA [supplemental ref 75] 1998 ARF Oxygen NPPV ED No Hospital 4 0 Wysocki M [supplemental ref 76] 1995 ARF Oxygen NPPV ICU No NR NR ICU 7 10 Zhan Q [supplemental ref 77] 2012 ARF Oxygen NPPV ICU No Hospital 1 5 Antonelli M [supplemental ref 3] 1998 ARF ETT NPPV ICU Yes Hospital

14 Gunduz M [supplemental ref 32] 2005 ARF ETT CPAP ICU No Hospital 2 7 Honrubia T [supplemental ref 36] 2005 ARF ETT NPPV ICU Yes Hospital Esteban A [supplemental ref 22] 2004 Postextubatio n ARF Keenan SP [supplemental ref 37] 2002 Postextubatio n ARF Antonelli M [supplemental ref 3] 2000 Postoperative ARF Auriant I [supplemental ref 6] 2001 Postoperative ARF Squadrone V [supplemental ref 63] 2005 Postoperative ARF PREVENTION Oxygen NPPV ICU Yes NR NR ICU Oxygen NPPV ICU Yes Hospital Oxygen NPPV ICU No Hospital 7 11 Oxygen NPPV ICU No days 3 9 Oxygen CPAP ICU No Hospital 0 3 Ferrer M [supplemental ref 26] 2009 Ferrer M [supplemental ref 27] 2006 Nava S [supplemental ref 51] 2005 Ornico SR [supplemental ref 52] 2013 Su CL [supplemental ref 65] 2012 Al Jaaly E [supplemental ref 1] 2013 Prevention of postextub. ARF (high risk) Prevention of postextub. ARF (high risk) Prevention of postextub. ARF (high risk) Prevention of postextub. ARF (unselected) Prevention of postextub. ARF (unselected) Prevention postoperat. ARF (cardiac surgery) Oxygen NPPV ICU Yes Hospital 6 16 Oxygen NPPV ICU Yes Hospital Oxygen NPPV ICU No Hospital 6 9 Oxygen NPPV ICU No Hospital 0 4 Oxygen NPPV ICU Yes NR NR ICU 3 2 Oxygen NPPV ICU Yes Hospital

15 Böhner H [supplemental ref 9] 2002 FagevikOlsen M [supplemental ref 23] 2002 Barbagallo M [supplemental ref 7] 2012 Lorut C [supplemental ref 45] 2013 Perrin C [supplemental ref 56] 2007 Wong DT [supplemental ref 74] 2011 Zoremba M [supplemental ref 78] 2011 Antonelli M [supplemental ref 5] 2002 Prevention postoperat. ARF (vascular surgery) Prevention postoperat. ARF (vascular surgery) Prevention postoperat. ARF (lung surgery) Prevention postoperat. ARF (lung surgery) Prevention postoperat. ARF (lung surgery) Prevention postoperat. ARF (obese patients) Prevention postoperat. ARF (obese patients) Bronchoscop y in hypoxemicpts Oxygen CPAP ICU No Hospital 4 0 Physiothera py CPAP ICU No NR NR 30 days 1 4 Oxygen CPAP ICU No Hospital 1 0 Oxygen NPPV ICU No NR NR 30 days 4 9 Oxygen NPPV ICU No Hospital 0 0 Oxygen NPPV PACU No NR NR PACU 0 0 Oxygen NPPV ICU No NR NR 48 hours 0 0 Oxygen NPPV ICU No NR NR ICU 4 7 NIV APPLIED TO FACILITATE AN EARLIER EXTUBATION Ferrer M [supplemental ref 24] 2003 Earlier extubation (failed T- piece trial) ETT NPPV ICU No NR NR 90 days

16 Girault C [supplemental ref 30] 2011 Girault C [supplemental ref 28] 1999 Nava S [supplemental ref 48] 1998 Trevisan CE [supplemental ref70] 2008 Collaborating Research Group For Noninvasive Mech anical Ventilation Of Chinese Respiratory Soci ety [supplemental ref 12] 2005 Vaschetto R [supplemental ref 71] 2012 Earlier extubation (failed T- piece trial) Earlier extubation (failed T- piece trial) Earlier extubation (failed T- piece trial) Earlier extubation (failed T- piece trial) Earlier extubation (accelerated, in pulmonary infection) Earlier extubation (accelerated in hypoxemic pts) a Crossover: crossover between study groups allowed or not in case of treatment failure; ETT NPPV ICU No Hospital ETT NPPV ICU No days 0 2 ETT NPPV ICU No NR NR 60 days ETT NPPV ICU No Hospital 9 10 ETT NPPV ICU No Hospital 1 7 ETT NPPV ICU No Hospital 2 3 Abbreviations: CPAP: continuous positive airway pressure; NPPV: non-invasive positive pressure ventilation; NIV: non-invasive ventilation; COPD: chronic obstructive pulmonary disease; ARF: acute respiratory failure; ETT: endotracheal tube; ED: emergency department; PACU: post anesthesia care unit; NR: not reported; ICU: intensive care unit. 16

17 Supplemental table2: Sensitivity analyses Sensitivity analyses performed by sequential removal of each study and re-analysis of the remaining dataset (producing a new analysis for each study removed), and by performing sub-analyses on specific subsets (defined by setting, by presence of crossovers between cases and controls, by year of publications and by comparator) confirm overall results. LongestFollow up Mortality Sensitivity analysis performed by sequential removal of studies [95 % CI] Hospital Mortality Overall All 95% CI lie within [ ] All 95% CI lie within [ ] Treatment All 95% CI lie within [ ] All 95% CI lie within [ ] Prevention Excluding Ferrer M (2009) the significance is lost (95%CI [ ]) Quantitative data analysis with Egger Test (p 1 ), Begg Test (p 2 ) Overall p 1 =3, p 2 =0.36 a p 1 =0.16; p 2 =0.6 Treatment p 1 =5, p 2 =0.34 a p 1 =0.39; p Prevention p 1 =0.59; p 2 =0.64 ///// Sensitivity analysis publicationyear Before 2002 p<1 p<1 After 2002 p<1 p<1 Sensitivity analysis by setting Ward p = 9 p<1 ICU p<1 p = 1 Emergency department p = 0.13 p = 0.05 Out of hospital p = 0.10 p = 0.12 Sensitivity analysis by comparator Oxygen p<1 p<1 Endotracheal tube p<1 p = 2 ///// CI: confidence interval; ICU: intensive care unit; a Trim & Fill analysis was performed, and confirmed previous results (no trimming performed, data unchanged) 17

18 Supplemental figure 1) Flow diagram for the selection of articles 1322 abstracts retrieved from database searches and additional hints 1189 titles/abstracts not eligible for inclusion 133 abstracts eligible for inclusion and detailed assessment 78 articles finally included in the analysis 55 where excluded because: - NIV was applied in all groups - Included only patients with expected low short-term survival (eg oncologic patients) - Mortality data were not available and could not be obtained by the authors - Methodology was unclear or not reported. 18

19 2) Forest plot of the effect of NIV treatment on mortalityin different settings at the longest follow up available (RR= Risk ratio) Study ID COPD Angus RM (1996) Brochard L (1995) Collaborative Research Group Of NIV For COPD (2005) Conti G (2002) Dhamija A (2005) Dikensoy O (2002) Keenan SP (2005) Khilnani GC (2010) Nava S (2011) Pastaka C (2007) Plant PK (2000) Çelikel T (1998) Barbè F (1996) Subtotal (I-squared = 0.0%, p = 0.965) ARF Antonelli M (1998) Confalonieri M (1999) Delclaux C (2000) Ferrer M (2003) Gunduz M (2005) Hernandez G (2010) Hilbert G (2001) Honrubia T (2005) Kramer N (1995) Martin TJ (2000) Roessler MS (2012) Squadrone V (2010) Thompson J (2008) Thys F (2002) Wermke M (2012) Wood KA (1998) Wysocki M (1995) Zhan Q (2012) Cosentini R (2010) Subtotal (I-squared = 19.9%, p = 0.217) TREATMENT POSTOPERATIVE ARF Antonelli M (2000) Auriant I (2001) Squadrone V (2005) Subtotal (I-squared = 0.0%, p = 0.451) APE Crane S (2004) Ducros L (2011) Frontin P (2011) Gray A (2008) Kelly Ca (2002) L'Her E (2004) Levitt MA (2001) Lin M (1995) Masip J (2000) Nava S (2003) Park M (2001) Park M (2004) Sharon A (2000) Takeda S (1998) Takeda S (1997) Weitz G (2007) Schmidbauer W (2011) Subtotal (I-squared = 0.0%, p = 0.535) TREATMENT POST-EXTUBATION ARF Esteban A (2004) Keenan SP (2002) Subtotal (I-squared = 39.3%, p = 0.199) ASTHMA Gupta D (2010) Soma T (2008) Sorokski A (2003) Subtotal (I-squared =.%, p =.) Heterogeneity between groups: p = Overall (I-squared = 13.0%, p = 0.217) RR (95% CI) 0.13 (0.01, 2.16) 0.33 (0.11, 0.93) 0.58 (0.24, 1.45) 0.57 (0.25, 1.26) 0.36 (0.02, 8.07) 0.50 (0.05, 5.01) 0.54 (0.05, 5.59) 1.50 (0.28, 8.04) 0.64 (0.41, 1.01) 0.33 (0.01, 7.74) 0.50 (0.26, 0.95) 0.33 (0.01, 7.58) (Excluded) 0.56 (0.42, 0.74) 0.50 (0.25, 1.00) 0.70 (0.31, 1.58) 1.04 (0.61, 1.78) 0.50 (0.26, 0.96) 0.31 (0.07, 1.35) 1.00 (0.07, 15.12) 0.62 (0.40, 0.95) 0.76 (0.40, 1.45) 0.47 (0.05, 4.65) 0.45 (0.18, 1.17) 0.35 (0.04, 3.11) 0.20 (0.07, 0.59) 0.40 (0.16, 1.03) 2.00 (0.21, 18.69) 1.20 (0.67, 2.14) 6.35 (0.38, ) 0.67 (0.32, 1.41) 0.18 (0.02, 1.41) (Excluded) 0.66 (0.54, 0.80) 0.64 (0.31, 1.30) 0.33 (0.10, 1.08) 0.14 (0.01, 2.71) 0.51 (0.28, 0.92) 0.42 (0.14, 1.20) 0.83 (0.33, 2.07) 0.89 (0.32, 2.48) 0.93 (0.70, 1.25) 0.33 (0.07, 1.45) 0.92 (0.48, 1.76) 0.81 (0.19, 3.51) 0.86 (0.44, 1.66) 0.19 (0.01, 3.71) 0.67 (0.25, 1.77) 1.94 (0.09, 43.50) 0.25 (0.07, 0.92) 5.00 (0.26, 98.00) 0.14 (0.02, 0.98) 0.33 (0.04, 2.85) 1.30 (0.09, 18.33) (Excluded) 0.80 (0.65, 0.99) 1.75 (0.99, 3.09) 0.99 (0.52, 1.91) 1.37 (0.89, 2.11) (Excluded) (Excluded) (Excluded). (.,.) 0.72 (0.63, 0.81) % Weight

20 3) Forest plot on the effect of different types of preventive NIV on mortality at the longest follow up available (RR = Risk Ratio) Study ID RR (95% CI) Events, Events, % Treatment Control Weight PREVENTION POSTOPERATIVE ARF Al Jaaly E (2013) 1.05 (0.07, 16.39) 1/63 1/ Barbagallo M (2012) 3.00 (0.13, 70.42) 1/26 0/ Böhner H (2002) 9.54 (0.52, ) 4/99 0/ Fagevik Olsen M (2002) 0.26 (0.03, 2.25) 1/34 4/ Lorut C (2013) 0.44 (0.14, 1.40) 4/181 9/ Perrin C (2007) (Excluded) 0/14 0/18 Wong DT (2011) (Excluded) 0/43 0/38 Zoremba M (2011) (Excluded) 0/30 0/30 Subtotal (I-squared = 25.9%, p = 0.249) 0.67 (0.28, 1.61) 11/490 14/ PREVENTION ARF Antonelli M (2002) 0.57 (0.22, 1.49) 4/13 7/ Subtotal (I-squared =.%, p =.) 0.57 (0.22, 1.49) 4/13 7/ PREVENTION POST-EXTUBATION ARF Ferrer M (2006) 0.79 (0.46, 1.34) 18/79 24/ Ferrer M (2009) 0.36 (0.15, 0.85) 6/54 16/ Nava S (2005) 0.68 (0.26, 1.77) 6/48 9/ Ornico SR (2013) 0.11 (0.01, 1.94) 0/20 4/ Su CL (2012) 1.51 (0.26, 8.97) 3/202 2/ Subtotal (I-squared = 14.2%, p = 0.324) 0.65 (0.44, 0.96) 33/403 55/ Heterogeneity between groups: p = Overall (I-squared = 1.3%, p = 0.429) 0.64 (0.46, 0.90) 48/906 76/

21 4) Forest plot of on the effect of different types of NIV used to allow an earlier extubation on mortality at the longest follow up available (RR=Risk Ratio) Study % ID RR (95% CI) Weight WEANING Collaborating Research Group for NIV Of Chinese Respiratory Society (2005) 0.13 (0.02, 1.02) 1.15 Ferrer M (2003) 0.48 (0.23, 1.03) 8.39 Girault C (2011) 1.79 (0.97, 3.29) Girault C (1999) 0.19 (0.01, 3.66) 0.55 Nava S (1998) 0.78 (0.60, 1.03) Trevisan CE (2008) 1.19 (0.56, 2.53) 8.51 Vaschetto R (2012) 0.67 (0.14, 3.17) 1.99 Subtotal (I-squared = 54.8%, p = 0.039) 0.84 (0.67, 1.05) 10 Heterogeneity between groups: p =. Overall (I-squared = 54.8%, p = 0.039) 0.84 (0.67, 1.05)

22 5) Forest plot on the effect of NIV treatment in different settings on hospital mortality (RR= Risk Ratio) Study ID COPD Brochard L (1995) Collaborative Research Group Of NIV For COPD (2005) Conti G (2002) Dhamija A (2005) Dikensoy O (2002) Keenan SP (2005) Khilnani GC (2010) Nava S (2011) Pastaka C (2007) Plant PK (2000) Çelikel T (1998) Barbè F (1996) Subtotal (I-squared = 0.0%, p = 0.740) ARF Antonelli M (1998) Confalonieri M (1999) Delclaux C (2000) Gunduz M (2005) Hernandez G (2010) Hilbert G (2001) Honrubia T (2005) Kramer N (1995) Squadrone V (2010) Thompson J (2008) Thys F (2002) Wood KA (1998) Zhan Q (2012) Cosentini R (2010) Subtotal (I-squared = 29.0%, p = 0.153) TREATMENT POSTOPERATIVE ARF Antonelli M (2000) Auriant I (2001) Squadrone V (2005) Subtotal (I-squared = 0.0%, p = 0.451) APE Crane S (2004) Ducros L (2011) Kelly Ca (2002) L'Her E (2004) Levitt MA (2001) Lin M (1995) Masip J (2000) Nava S (2003) Park M (2001) Park M (2004) Sharon A (2000) Takeda S (1998) Weitz G (2007) Schmidbauer W (2011) Subtotal (I-squared = 0.0%, p = 0.565) TREATMENT POST-EXTUBATION ARF Keenan SP (2002) Subtotal (I-squared =.%, p =.) ASTHMA Soma T (2008) Sorokski A (2003) Subtotal (I-squared =.%, p =.) Heterogeneity between groups: p = Overall (I-squared = 0.0%, p = 0.526) % RR (95% CI) Weight 0.33 (0.11, 0.93) (0.24, 1.45) (0.48, 3.86) (0.02, 8.07) (0.05, 5.01) (0.05, 5.59) (0.28, 8.04) (0.02, 1.32) (0.01, 7.74) (0.26, 0.95) (0.01, 7.58) 0.27 (Excluded) 0.56 (0.38, 0.82) (0.25, 1.00) (0.45, 3.04) (0.61, 1.78) (0.07, 1.35) (0.07, 15.12) (0.40, 0.95) (0.40, 1.45) (0.05, 4.65) (0.07, 0.59) (0.16, 1.03) (0.21, 18.69) (0.38, ) (0.02, 1.41) 0.62 (Excluded) 0.65 (0.52, 0.83) (0.31, 1.30) (0.10, 1.08) (0.01, 2.71) (0.28, 0.92) (0.14, 1.20) (0.33, 2.07) (0.07, 1.45) (0.48, 1.76) (0.19, 3.51) (0.20, 2.22) (0.01, 3.71) (0.25, 1.77) (0.09, 43.50) (0.07, 0.92) (0.26, 98.00) (0.02, 0.98) (0.09, 18.33) 0.37 (Excluded) 0.64 (0.45, 0.90) (0.52, 1.91) (0.52, 1.91) 6.16 (Excluded) (Excluded). (.,.) 0.64 (0.54, 0.75)

23 6) Forest plot on the effect ofniv used as a preventive treatment on hospital mortality (RR=Risk Ratio) Study ID RR (95% CI) % Weight PREVENTION POSTOPERATIVE ARF Al Jaaly E (2013) Barbagallo M (2012) Böhner H (2002) Perrin C (2007) Subtotal (I-squared = 0.0%, p = 0.557) 1.05 (0.07, 16.39) 3.00 (0.13, 70.42) 9.54 (0.52, ) (Excluded) 2.98 (0.55, 16.12) PREVENTION POST-EXTUBATION ARF Ferrer M (2006) Ferrer M (2009) Nava S (2005) Ornico SR (2013) Subtotal (I-squared = 0.0%, p = 0.624) 0.72 (0.38, 1.36) 0.53 (0.21, 1.32) 0.68 (0.26, 1.77) 0.11 (0.01, 1.94) 0.63 (0.40, 0.99) Heterogeneity between groups: p = Overall (I-squared = 0.0%, p = 0.426) 0.70 (0.45, 1.08)

24 7) Forest plot on the effect of NIV used to allow an earlier extubation on hospital mortality (RR=Risk Ratio) Study % ID RR (95% CI) Weight WEANING Collaborating Research Group for NIV Of Chinese Respiratory Society (2005) 0.13 (0.02, 1.02) 4.54 Girault C (2011) 1.79 (0.97, 3.29) Girault C (1999) 0.19 (0.01, 3.66) 2.18 Trevisan CE (2008) 1.19 (0.56, 2.53) Vaschetto R (2012) 0.67 (0.14, 3.17) 7.88 Subtotal (I-squared = 51.1%, p = 0.085) 1.22 (0.79, 1.89) 10 Heterogeneity between groups: p =. Overall (I-squared = 51.1%, p = 0.085) 1.22 (0.79, 1.89)

25 1.5 se(logrr) ) Funnel plot for the risk ofhospital mortality, by type of NIV therapy (RR=Risk Ratio, SE= Standard Error) Funnel plot with pseudo 95% confidence limits log RR prevention weaning Lower CI treatment Lower CI Pooled 25

26 1.5 1 se(logrr).5 0 9) Funnel plot for the risk of hospital mortality for NIV treatment (RR=Risk Ratio, SE= Standard Error) Funnel plot with pseudo 95% confidence limits log RR 26

27 1.5 1 se(logrr) ) Funnel plot for the risk of mortality at the longest follow-up available. Small study bias is suggested from visual evaluation, however results of the analysis were confirmed by Trim and Fill method(rr=risk Ratio, SE= Standard Error). Funnel plot with pseudo 95% confidence limits log RR 27

28 1.5 1 se(logrr) ) Funnel plot for the risk of mortality at longest follow-up available, for NIV treatment.small study bias is suggested from visual evaluation, however results of the analysis were confirmed by Trim and Fill method(rr=risk Ratio, SE= Standard Error). Funnel plot with pseudo 95% confidence limits log RR 28

29 1.5 1 se(logrr) ) Funnel plot for the risk of mortality at longest follow-up available, for NIV used as preventive treatment (RR=Risk Ratio, SE= Standard Error) Funnel plot with pseudo 95% confidence limits log RR 29

30 -2-1 log_rr ) Univariate meta-regression of follow-up length against log-risk mortality showing no significant effect for length of follow up on mortality (logrr). (RR= Risk Ratio) Lenght of follow up (days) n=69, Slope Coefficient 05 [-2 ; 1] ;p=

31 -2-1 log_rr ) Univariatemetaregression of publication year on log-risk mortality showing no significant effect for publication year on mortality (logrr) year n=69;slope Coefficient = [-9; 0.044];p=

32 15) Cumulative meta-analysis for the risk of mortality, showing a constant effect of NIV over time. The effect of NIV on mortality has been statistically significant since (RR=Risk Ratio) Study ID Lin M (1995) Kramer N (1995) Brochard L (1995) Wysocki M (1995) Barbè F (1996) Angus RM (1996) Takeda S (1997) Nava S (1998) Çelikel T (1998) Takeda S (1998) Wood KA (1998) Antonelli M (1998) Girault C (1999) Confalonieri M (1999) Delclaux C (2000) Masip J (2000) Antonelli M (2000) Sharon A (2000) Plant PK (2000) Martin TJ (2000) Levitt MA (2001) Hilbert G (2001) Park M (2001) Auriant I (2001) Keenan SP (2002) Antonelli M (2002) Kelly Ca (2002) Böhner H (2002) Fagevik Olsen M (2002) Conti G (2002) Thys F (2002) Dikensoy O (2002) Ferrer M (2003) Sorokski A (2003) Nava S (2003) Ferrer M (2003) L'Her E (2004) Crane S (2004) Park M (2004) Esteban A (2004) Collaborating Research Group for NIV Of Chinese Respiratory Society (2005) Squadrone V (2005) Dhamija A (2005) Nava S (2005) Keenan SP (2005) Gunduz M (2005) Collaborative Research Group Of NIV For COPD (2005) Honrubia T (2005) Ferrer M (2006) Weitz G (2007) Perrin C (2007) Pastaka C (2007) Trevisan CE (2008) Thompson J (2008) Gray A (2008) Soma T (2008) Ferrer M (2009) Cosentini R (2010) Gupta D (2010) Squadrone V (2010) Khilnani GC (2010) Hernandez G (2010) Girault C (2011) Nava S (2011) Ducros L (2011) Schmidbauer W (2011) Frontin P (2011) Zoremba M (2011) Wong DT (2011) Zhan Q (2012) Wermke M (2012) Roessler MS (2012) Vaschetto R (2012) Barbagallo M (2012) Su CL (2012) Al Jaaly E (2013) Ornico SR (2013) Lorut C (2013) RR (95% CI) 0.86 (0.44, 1.66) 0.81 (0.43, 1.53) 0.60 (0.35, 1.03) 0.62 (0.40, 0.96) 0.62 (0.40, 0.96) 0.57 (0.37, 0.89) 0.56 (0.37, 0.85) 0.63 (0.48, 0.84) 0.63 (0.47, 0.83) 0.58 (0.44, 0.77) 0.63 (0.48, 0.83) 0.61 (0.47, 0.78) 0.59 (0.46, 0.77) 0.60 (0.47, 0.77) 0.67 (0.54, 0.83) 0.66 (0.53, 0.82) 0.66 (0.53, 0.81) 0.67 (0.54, 0.83) 0.65 (0.53, 0.79) 0.63 (0.52, 0.77) 0.64 (0.53, 0.78) 0.64 (0.53, 0.76) 0.64 (0.53, 0.77) 0.63 (0.52, 0.75) 0.65 (0.55, 0.77) 0.65 (0.55, 0.76) 0.64 (0.54, 0.75) 0.66 (0.55, 0.77) 0.65 (0.55, 0.77) 0.64 (0.55, 0.76) 0.65 (0.55, 0.76) 0.65 (0.55, 0.76) 0.64 (0.55, 0.75) 0.64 (0.55, 0.75) 0.64 (0.55, 0.75) 0.63 (0.54, 0.74) 0.64 (0.56, 0.75) 0.64 (0.55, 0.74) 0.63 (0.54, 0.73) 0.68 (0.59, 0.78) 0.67 (0.58, 0.77) 0.66 (0.58, 0.76) 0.66 (0.58, 0.76) 0.66 (0.58, 0.76) 0.66 (0.58, 0.76) 0.66 (0.57, 0.75) 0.65 (0.57, 0.75) 0.66 (0.58, 0.75) 0.66 (0.58, 0.76) 0.67 (0.59, 0.76) 0.67 (0.59, 0.76) 0.66 (0.58, 0.76) 0.68 (0.60, 0.77) 0.67 (0.59, 0.76) 0.71 (0.63, 0.79) 0.71 (0.63, 0.79) 0.70 (0.62, 0.78) 0.70 (0.62, 0.78) 0.70 (0.62, 0.78) 0.68 (0.61, 0.77) 0.69 (0.61, 0.77) 0.69 (0.61, 0.77) 0.71 (0.64, 0.79) 0.71 (0.64, 0.79) 0.71 (0.64, 0.79) 0.71 (0.64, 0.79) 0.71 (0.64, 0.79) 0.71 (0.64, 0.79) 0.71 (0.64, 0.79) 0.71 (0.64, 0.79) 0.72 (0.65, 0.80) 0.72 (0.65, 0.79) 0.72 (0.65, 0.79) 0.72 (0.65, 0.80) 0.72 (0.65, 0.80) 0.72 (0.65, 0.80) 0.72 (0.65, 0.79) 0.71 (0.64, 0.79)