Non-invasive weaning from ventilation reduces mortality, ventilator-associated pneumonia, and length of stay in intubated adults.

Objective: To review the evidence as to whether early extubation with immediate application of non-invasive ventilation reduces mortality and ventilator-associated pneumonia and improves other outcomes in criticallyill adults receiving invasive ventilation. Data sources: Medline, Embase, CENTRAL, searched up to April, 2008. This search was supplemented by hand-searching of conference proceeding and citation tracking. Study selection: Randomised and quasi-randomised controlled trials involving adults with respiratory failure who required invasive ventilation for at least 24 hours in which extubation with immediate application of noninvasive ventilation was compared to continued invasive weaning. Outcome measures were mortality, ventilatorassociated pneumonia, weaning failure, length of stay in intensive care or hospital, total duration of ventilation (invasive and non-invasive), duration of ventilation related to weaning (after randomisation), duration of invasiveNon-invasive weaning from ventilation reduces mortality, ventilator-associated pneumonia, and length of stay in intubated adults