scholarly journals The efficacy and safety of high-flow nasal cannula therapy in patients with COPD and type II respiratory failure: a meta-analysis and systematic review

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Zhiping Xu ◽  
Lingxia Zhu ◽  
Jingye Zhan ◽  
Lijun Liu
Keyword(s):  
Respiratory Failure ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
High Flow ◽  
Nasal Cannula ◽  
Clinical Settings ◽  
Type Ii ◽  
Efficacy And Safety ◽  
High Flow Nasal Cannula ◽  
Meta Analyses

Abstract Background High-flow nasal cannula (HFNC) and noninvasive ventilation (NIV) have been used for the treatment of COPD and respiratory failure in clinical settings. We aimed to evaluate the efficacy and safety of HFNC therapy in patients with COPD and type II respiratory failure, to provide evidence to the clinical COPD management. Methods We searched Cochrane et al. databases up to Dec 31, 2020 for randomized controlled trials (RCTs) on the use of HFNC therapy in patients with COPD and type II respiratory failure. Two researchers independently screened the literature according to the inclusion and exclusion criteria, and evaluated the quality of the literature and extracted data. We used Revman5.3 software for statistical analysis of collected data. Results A total of 6 RCTs involving 525 COPD and type II respiratory failure patients. Meta-analyses indicated that compared with NIV, HFNC could significantly reduce PaCO2 level (MD = − 2.64, 95% CI (− 3.12 to − 2.15)), length of hospital stay ((MD = – 1.19, 95 CI (− 2.23 to − 0.05)), the incidence of nasal facial skin breakdown ((OR = 0.11, 95% CI (0.03–0.41)). And there were no significant differences between the two groups in PaO2 ((MD = 2.92, 95% CI (− 0.05 to 5.90)), incidence of tracheal intubation ((OR = 0.74, 95% CI (0.34–1.59)) and mortality (OR = 0.77, 95% CI (0.28–2.11)). Conclusions HFNC is more advantageous over NIV in the treatment of COPD and type II respiratory failure. Future studies with larger sample size and strict design are needed to further elucidate the role of HFNC in COPD and respiratory failure.

scholarly journals The Impact of High-Flow Nasal Cannula on the Outcome of Immunocompromised Patients with Acute Respiratory Failure: A Systematic Review and Meta-Analysis

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 693 ◽  
Author(s):  
Cheng ◽  
Chang ◽  
Wang ◽  
Hsiao ◽  
Lai ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Meta Analysis ◽  
High Flow ◽  
Nasal Cannula ◽  
Immunocompromised Patients ◽  
Intubation Rate ◽  
High Flow Nasal Cannula ◽  
Control Groups ◽  
And Control

Background and objectives: High-flow nasal cannula (HFNC) can be used as a respiratory support strategy for patients with acute respiratory failure (ARF). However, no clear evidence exists to support or oppose HFNC use in immunocompromised patients. Thus, this meta-analysis aims to assess the effects of HFNC, compared to conventional oxygen therapy (COT) and noninvasive ventilation (NIV), on the outcomes in immunocompromised patients with ARF. The Pubmed, Embase and Cochrane databases were searched up to November 2018. Materials and Methods: Only clinical studies comparing the effect of HFNC with COT or NIV for immunocompromised patients with ARF were included. The outcome included the rate of intubation, mortality and length of stay (LOS). Results: A total of eight studies involving 1433 immunocompromised patients with ARF were enrolled. The pooled analysis showed that HFNC was significantly associated with a reduced intubation rate (risk ratio (RR), 0.83; 95% confidence interval (CI), 0.74–0.94, I2 = 0%). Among subgroup analysis, HFNC was associated with a lower intubation rate than COT (RR, 0.86; 95% CI, 0.75–0.95, I2 = 0%) and NIV (RR, 0.59; 95% CI, 0.40–0.86, I2 = 0%), respectively. However, there was no significant difference between HFNC and control groups in terms of 28-day mortality (RR, 0.78; 95% CI, 0.58–1.04, I2 = 48%), and intensive care unit (ICU) mortality (RR, 0.87; 95% CI, 0.73–1.05, I2 = 57%). The ICU and hospital LOS were similar between HFNC and control groups (ICU LOS: mean difference, 0.49 days; 95% CI, −0.25–1.23, I2 = 69%; hospital LOS: mean difference, −0.12 days; 95% CI, −1.86–1.61, I2 = 64%). Conclusions: Use of HFNC may decrease the intubation rate in immunocompromised patients with ARF compared with the control group, including COT and NIV. However, HFNC could not provide additional survival benefit or shorten the LOS. Further large, randomized controlled trials are needed to confirm these findings.

1093: PALLIATIVE HIGH-FLOW NASAL CANNULA IN ACUTE RESPIRATORY FAILURE: SYSTEMATIC REVIEW AND META-ANALYSIS

2018 ◽  
Vol 46 (1) ◽  
pp. 530-530
Author(s):  
Aniket Mittal ◽  
Abdul Majzoub ◽  
Ognjen Gajic ◽  
Hassan Murad ◽  
Michael Wilson
Keyword(s):  
Systematic Review ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Meta Analysis ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula

scholarly journals High-Flow Nasal Cannula in Hypercapnic Respiratory Failure: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Yongkang Huang ◽  
Wei Lei ◽  
Wenyu Zhang ◽  
Jian-an Huang
Keyword(s):  
Systematic Review ◽  
Respiratory Failure ◽  
Cohort Studies ◽  
Meta Analysis ◽  
High Flow ◽  
Nasal Cannula ◽  
Cochrane Library ◽  
Intubation Rate ◽  
High Flow Nasal Cannula ◽  
Hypercapnic Respiratory Failure

Background. Although the efficacy and safety of high-flow nasal cannula (HFNC) in hypoxemic respiratory failure are widely recognized, it is yet unclear whether HFNC can effectively reduce the intubation rate and mortality in hypercapnic respiratory failure. We performed a systematic review and meta-analysis to assess the safety and efficiency of HFNC in these patients. Methods. A systematic search of PubMed, Embase, and Cochrane Library (CENTRAL) was carried out. Two reviewers independently screened all references according to the inclusion criteria. We used the Cochrane risk-of-bias tool and the Newcastle–Ottawa Quality Assessment Scale to assess the quality of randomized controlled trials (RCTs) and cohort studies, respectively. Data from eligible trials were extracted for the meta-analysis. Results. Eight studies with a total of 621 participants were included (six RCTs and two cohort studies). Our analysis showed that HFNC is noninferior to noninvasive ventilation (NIV) with respect to intubation rate in both RCTs (OR = 0.92, 95% CI: 0.45–1.88) and cohort studies (OR = 0.94, 95% CI: 0.55–1.62). Similarly, the analysis of cohort studies showed no difference in reducing mortality rates (OR = 0.96, 95% CI: 0.42–2.20). Based on RCTs, NIV seemed more effective in reducing mortality (OR = 1.33, 95% CI: 0.68–2.60), but the intertreatment difference was not statistically significant. Furthermore, no significant differences were found between HFNC and NIV relating to change of blood gas analysis or respiratory rate (MD = −0.75, 95% CI: −2.6 to 1.09). Likewise, no significant intergroup differences were found with regard to intensive care unit stay (SMD = −0.07, 95% CI: 0.26 to 0.11). Due to a physiological friendly interface and variation, HFNC showed a significant advantage over NIV in patients’ comfort and complication of therapy. Conclusion. Despite the limitations noted, HFNC may be an effective and safe alternative to prevent endotracheal intubation and mortality when NIV is unsuitable in mild-to-moderate hypercapnia. Further high-quality studies are needed to validate these findings.

scholarly journals Efficacy and Safety of Heated humidified high-flow nasal cannula for Preventing Extubation Failure in Neonates: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Jia Liu ◽  
Hongyan Qiu ◽  
Baihua Zheng ◽  
Lu Jin ◽  
Jing Chen
Keyword(s):  
Meta Analysis ◽  
Extubation Failure ◽  
Incidence Rates ◽  
High Flow ◽  
Nasal Cannula ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
High Flow Nasal Cannula ◽  
Nasal Trauma

Abstract Background: Heated humidified high-flow nasal cannula (HHHFNC) is gaining popularity as a mode of respiratory support. We updated a meta-analysis examining the efficacy and safety of HHHFNC compared with nasal continuous positive airway pressure (NCPAP) for infants. Methods: Literature searches were conducted using PubMed, Cochrane Library, OVID, Embase, Web of Science, Chinese Biomedical Literature, Weipu Journal, Wanfang, and CNKI databases up to December 2020. Only randomized controlled trials (RCTs) of HHHFNC versus NCPAP in preventing extubation failure for infants were included. Results: A total of 13 RCTs research literatures involving 2395 infants were included in the Meta-analysis. The meta-analysis showed the following results. (1) In terms of efficacy, there were no significant differences between two groups in the treatment failure rate (RR: 1.00, 95%CI: 0.73 to 1.36, P=0.99) and reintubation rate (RR: 0.86, 95%CI: 0.70 to 1.06, P=0.16). While in term of safety, HHHFNC had a significant advantage over NCPAP in reducing the incidence rates of nasal trauma (RR: 0.27, 95%CI: 0.13 to 0.56, P=0.0005) and frequent hemorrhoid (RR: 0.40, 95%CI: 0.23 to 0.70, P=0.001).(2) In terms of secondary outcome measures, there were no significant differences between two groups in hospital mortality rate and incidence rates of BPD, ROP, IVH and duration of reaching full enteral feeding(P>0.05). HHHFNC demonstrated lower incidence of NEC (RR: 0.65, 95%CI: 0.43 to 0.98, P=0.04) than NCPAP. Conclusion:this meta-analysis showed that HHHFNC appears to be similar to NCPAP in efficacy of preventing extubation failure in infants. It is associated with significantly lower odds of nasal trauma, frequent hemorrhoid and NEC.

Sign in / Sign up

Export Citation Format

Share Document