Efeitos da ventilação não invasiva com pressão positiva nas vias aéreas em pacientes com asma agudizada sobre os desfechos clínicos: protocolo de revisão guarda-chuva

Abstract

Introduction: The use of noninvasive positive pressure ventilation in pediatric patients with acute asthma has shown positive effects on the airways by reducing the work of breathing, improving alveolar ventilation and consequently improving gas exchange. However, the scientific literature presents inconsistent results, revealing uncertainty about the benefits of positive pressure therapy in acute asthmatic patients. Objective: Investigate the effects of noninvasive positive pressure ventilation in pediatric patients with acute asthma through an umbrella review. Methods/design: an umbrella review protocol of systematic reviews that included randomized clinical trials with pediatric patients with acute asthma evaluating the effects of non-invasive ventilation compared to control without non-invasive ventilation. Searches: This is an umbrella review protocol of systematic reviews that will include randomized clinical trials with pediatric patients with acute asthma evaluating the effects of non-invasive positive pressure ventilation compared to control (without non-invasive positive pressure ventilation or usual care). Searches will be conducted in: MEDLINE, EMBASE, PEDro, PUBMED, Allied and AMED, CINAHL, LILACS, SCIELO, Scopus and Cochrane CENTRAL, ClinicalTrials.gov, ReBEC, and in the references of included studies. Study selection will be conducted by three authors. Bias risk will be assessed by two independent authors using the AMSTAR-2 tool and conflicts will be resolved through consensus (in case of disagreement, a third author will make the decision). In the meta-analysis, the inverse variance method and random-effects model will be considered. Continuous variables will be analyzed using weighted mean difference and dichotomous variables through relative risk (RR). I2 statistics will be used to estimate the amount of heterogeneity among studies. Expected outcomes: It is expected to produce a well-constructed umbrella review protocol in a scientifically rigorous manner with transparent methods aiming to clarify the inconsistent outcomes of systematic reviews on the use of non-invasive positive pressure ventilation in the airways of pediatric patients with acute asthma.