High-flow nasal cannula oxygen therapy versus conventional oxygen therapy in patients after planned extubation: a systematic review and meta-analysis

Critical Care

Jianrui Wei¹  Rui Zhang²  Haiyan Yin²  Youfeng Zhu²  Xiaoling Ye² 

[1] 0000 0004 1790 3548, grid.258164.c, Department of Cardiology, Guangzhou Red Cross Hospital, Medical College, Jinan University, Tongfuzhong Road No. 396, 510220, Guangzhou, Guangdong, China;0000 0004 1790 3548, grid.258164.c, Department of Intensive Care Unit, Guangzhou Red Cross Hospital, Medical College, Jinan University, Tongfuzhong Road No. 396, 510220, Guangzhou, Guangdong, China;

关键词: High-flow nasal cannula;    Oxygen therapy;    Mechanical ventilation;    Postextubation;   

DOI  :  10.1186/s13054-019-2465-y

来源: publisher

【 摘 要 】

BackgroundThe effect of high-flow nasal cannula (HFNC) therapy in patients after planned extubation remains inconclusive. We aimed to perform a rigorous and comprehensive systematic meta-analysis to robustly quantify the benefits of HFNC for patients after planned extubation by investigating postextubation respiratory failure and other outcomes.MethodWe searched MEDLINE, EMBASE, Web of Science, and the Cochrane Library from inception to August 2018. Two researchers screened studies and collected the data independently. Randomized controlled trials (RCTs) and crossover studies were included. The main outcome was postextubation respiratory failure.ResultsTen studies (seven RCTs and three crossover studies; HFNC group: 856 patients; Conventional oxygen therapy (COT) group: 852 patients) were included. Compared with COT, HFNC may significantly reduce postextubation respiratory failure (RR, 0.61; 95% CI, 0.41, 0.92; z = 2.38; P = 0.02) and respiratory rates (standardized mean differences (SMD), − 0.70; 95% CI, − 1.16, − 0.25; z = 3.03; P = 0.002) and increase PaO2 (SMD, 0.30; 95% CI, 0.04, 0.56; z = 2.23; P = 0.03). There were no significant differences in reintubation rate, length of ICU and hospital stay, comfort score, PaCO2, mortality in ICU and hospital, and severe adverse events between HFNC and COT group.ConclusionsOur meta-analysis demonstrated that compared with COT, HFNC may significantly reduce postextubation respiratory failure and respiratory rates, increase PaO2, and be safely administered in patients after planned extubation. Further large-scale, multicenter studies are needed to confirm our results.

【 授权许可】

CC BY