High-flow nasal cannula oxygen therapy versus conventional oxygen therapy in patients with acute respiratory failure: a systematic review and meta-analysis of randomized controlled trials

BMC Pulmonary Medicine

Research Article

Jianrui Wei¹  Rui Zhang²  Haiyan Yin²  Youfeng Zhu² 

[1] Department of Cardiology, Guangzhou Red Cross Hospital, Medical College, Jinan University, 510220, Guangzhou, Guangdong province, China;Department of Intensive Care Unit, Guangzhou Red Cross Hospital, Medical College, Jinan University, Tongfuzhong Road No. 396, 510220, Guangzhou, Guangdong province, China;

关键词: High-flow nasal cannula;    Mortality;    Acute respiratory failure;    Treatment;   

DOI  :  10.1186/s12890-017-0525-0

 received in 2017-04-10, accepted in 2017-11-24,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAcute respiratory failure (ARF) is a common and life-threatening medical emergency in patients admitted to the hospital. Currently, there is a lack of large-scale evidence on the use of high-flow nasal cannulas (HFNC) in patients with ARF. In this systematic review and meta-analysis, we evaluated whether there were differences between HFNC therapy and conventional oxygen therapy (COT) for treating patients with ARF.MethodsThe EMBASE, Medline, and Wanfang databases and the Cochrane Library were searched. Two investigators independently collected the data and assessed the quality of each study. Randomized controlled trials that compared HFNC therapy with COT in patients with ARF were included. RevMan 5.3 was used to conduct the meta-analysis.ResultsFour studies that involved 703 patients with ARF were included, with 371 patients in the HFNC group and 332 patients in the COT group. In the overall estimates, there were no significant differences between the HFNC and COT groups in the rates of escalation of respiratory support (RR, 0.68; 95% CI, 0.37, 1.27; z = 1.20, P = 0.23), intubation (RR, 0.74; 95% CI, 0.55, 1.00; z = 1.95, P = 0.05), mortality (RR, 0.82; 95% CI, 0.36, 1.88; z = 0.47, P = 0.64), or ICU transfer (RR, 1.09; 95% CI, 0.57, 2.09; z = 0.26, P = 0.79) during ARF treatment. However, the subgroup analysis showed that HFNC therapy may decrease the rate of escalation of respiratory support (RR, 0.71; 95% CI, 0.53, 0.97; z = 2.15, P = 0.03) and the intubation rate (RR, 0.71; 95% CI, 0.53, 0.97; z = 2.15, P = 0.03) when ARF patients were treated with HFNC therapy for ≥24 h compared with COT.ConclusionsHFNC therapy was similar to COT in ARF patients. The subgroup analysis showed that HFNC therapy may decrease the rate of escalation of respiratory support and the intubation rate when ARF patients were treated with HFNC for ≥24 h compared with COT. Further high-quality, large-scale studies are needed to confirm our results.

【 授权许可】

CC BY   
© The Author(s). 2017