Ten RCTs were included in meta-analyses (n=1,153). Sample sizes varied from 16 to 702. The median Jadad score of included studies was 3. Most studies were judged as good quality.
Compared to continuous positive airway pressure, noninvasive pressure support ventilation had no significant differences in the rate of intubation (OR 0.80, 95% CI 0.43 to 1.49; 10 RCTs), occurrence of myocardial infarction (OR 0.8, 95% CI 0.36 to1.54; eight RCTs) and hospital mortality (OR 1.08, 95% CI 0.76 to1.54; 10 RCTs ).
Subgroup analyses showed that fixed pressure noninvasive pressure support ventilation was associated with a significant increase in myocardial infarction compared with continuous positive airway pressure (OR 5.06, 95% CI 1.66 to 15.44; two RCTs)
No statistically significant heterogeneity was observed. No evidence of publication bias was found according to visual scanning of forest plots and the statistical tests.