A Cochrane review [Abstract] 1 included 10 studies with a total of 191 subjects. 7 trials evaluated single treatment sessions only and one evaluated a six-week intervention. 6 trials (n=151) evaluated non-invasive ventilation (NIV) for airway clearance compared with an alternative chest physiotherapy method and showed that airway clearance may be easier with NIV and people with cystic fibrosis (CF) may prefer it. No evidence was found that NIV would increase sputum expectoration, but it did improve some lung function parameters. Three trials (n=27) evaluated NIV for overnight ventilatory support. Lung function and nocturnal transcutaneous carbon dioxide were evaluated within two trials. No clear differences were found between NIV compared with oxygen or room air except for exercise performance, which significantly improved with NIV compared to room air over six weeks.
Comment: The quality of evidence is downgraded by limitations in study quality, by imprecise results (few patients) and by inconsistency (heterogeneity in interventions and outcomes).
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