Table 1. Recommendations for Actionable PICO Questions
Clinical indication
a
Certainty of
evidence
b
Strength of
Recommendation
Prevention of hypercapnia in COPD
exacerbation
⊕⊕
Conditional against
Hypercapnia with COPD exacerbation
⊕⊕⊕⊕
Strong for
Cardiogenic pulmonary oedema
⊕⊕⊕
Strong for
Acute asthma exacerbation No recommendation
made
Immunocompromised
⊕⊕⊕
Conditional for
De novo respiratory failure No recommendation
made
Post-operative patients
⊕⊕⊕
Conditional for
Palliative care
⊕⊕⊕
Conditional for
Trauma
⊕⊕⊕
Conditional for
Pandemic viral illness No recommendation
made
Post-extubation in high-risk patients
c
(prophylaxis)
⊕⊕
Conditional for
Post-extubation respiratory failure
d
⊕⊕
Conditional against
Weaning in hypercapnic patients
⊕⊕⊕
Conditional for
a
All in the setting of acute respiratory failure
b
Certainty of effect estimates:
⊕⊕⊕⊕
, high;
⊕⊕⊕
, moderate;
⊕⊕
, low;
⊕
, very low.
c
Patients with unplanned extubation are a higher risk group and further studies are needed
to address the use of NIV in this group.
d
is recommendation may not apply to post-extubation CHF or COPD patients with
respiratory failure; further studies are needed.
