Yue-Nan Ni1, Jian Luo1, He Yu2, Dan Liu2, Bin-Miao Liang3, Zong-An Liang4. 1. Department of Respiratory and Critical Care, West China School of Medicine and West China Hospital, Sichuan University, 610041, China. 2. Department of Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, 610041, China. 3. Department of Respiratory and Critical Care, West China School of Medicine and West China Hospital, Sichuan University, 610041, China. Electronic address: liangbinmiao@163.com. 4. Department of Respiratory and Critical Care, West China School of Medicine and West China Hospital, Sichuan University, 610041, China. Electronic address: liangzatg@126.com.
Abstract
BACKGROUND: The effects of high flow nasal cannula (HFNC) on adult patients when used before mechanical ventilation (MV) are unclear. We aimed to determine the effectiveness of HFNC when used before MV by comparison to conventional oxygen therapy (COT) and noninvasive positive pressure ventilation (NIPPV). METHODS: The Pubmed, Embase, Medline, Cochrane Central Register of Controlled Trials (CENTRAL) as well as the Information Sciences Institute (ISI) Web of Science were searched for all the controlled studies that compared HFNC with NIPPV and COT when used before MV in adult patients. The primary outcome was the rate of endotracheal intubation and the secondary outcomes were intensive care unit (ICU) mortality and length of ICU stay (ICU LOS). RESULTS: Eight trials with a total of 1084 patients were pooled in our final studies. No significant heterogeneity was found in outcome measures. Compared both with COT and NIPPV, HFNC could reduce both of the rate of endotracheal intubation (OR 0.62, 95% CI 0.38-0.99, P=0.05; OR 0.48, 95% CI 0.31-0.73, P=0.0006) and ICU mortality (OR 0.47, 95% CI 0.24-0.93, P=0.03; OR 0.36, 95% CI 0.20-0.63, P=0.0004). As for the ICU LOS, we did not find any advantage of HFNC over COT or NIPPV. CONCLUSIONS: When used before MV, HFNC can improve the prognosis of patients compared both with the COT and NIPPV.
BACKGROUND: The effects of high flow nasal cannula (HFNC) on adult patients when used before mechanical ventilation (MV) are unclear. We aimed to determine the effectiveness of HFNC when used before MV by comparison to conventional oxygen therapy (COT) and noninvasive positive pressure ventilation (NIPPV). METHODS: The Pubmed, Embase, Medline, Cochrane Central Register of Controlled Trials (CENTRAL) as well as the Information Sciences Institute (ISI) Web of Science were searched for all the controlled studies that compared HFNC with NIPPV and COT when used before MV in adult patients. The primary outcome was the rate of endotracheal intubation and the secondary outcomes were intensive care unit (ICU) mortality and length of ICU stay (ICU LOS). RESULTS: Eight trials with a total of 1084 patients were pooled in our final studies. No significant heterogeneity was found in outcome measures. Compared both with COT and NIPPV, HFNC could reduce both of the rate of endotracheal intubation (OR 0.62, 95% CI 0.38-0.99, P=0.05; OR 0.48, 95% CI 0.31-0.73, P=0.0006) and ICU mortality (OR 0.47, 95% CI 0.24-0.93, P=0.03; OR 0.36, 95% CI 0.20-0.63, P=0.0004). As for the ICU LOS, we did not find any advantage of HFNC over COT or NIPPV. CONCLUSIONS: When used before MV, HFNC can improve the prognosis of patients compared both with the COT and NIPPV.
Authors: Amanda Corley; Claire M Rickard; Leanne M Aitken; Amy Johnston; Adrian Barnett; John F Fraser; Sharon R Lewis; Andrew F Smith Journal: Cochrane Database Syst Rev Date: 2017-05-30
Authors: Laura Evans; Andrew Rhodes; Waleed Alhazzani; Massimo Antonelli; Craig M Coopersmith; Craig French; Flávia R Machado; Lauralyn Mcintyre; Marlies Ostermann; Hallie C Prescott; Christa Schorr; Steven Simpson; W Joost Wiersinga; Fayez Alshamsi; Derek C Angus; Yaseen Arabi; Luciano Azevedo; Richard Beale; Gregory Beilman; Emilie Belley-Cote; Lisa Burry; Maurizio Cecconi; John Centofanti; Angel Coz Yataco; Jan De Waele; R Phillip Dellinger; Kent Doi; Bin Du; Elisa Estenssoro; Ricard Ferrer; Charles Gomersall; Carol Hodgson; Morten Hylander Møller; Theodore Iwashyna; Shevin Jacob; Ruth Kleinpell; Michael Klompas; Younsuck Koh; Anand Kumar; Arthur Kwizera; Suzana Lobo; Henry Masur; Steven McGloughlin; Sangeeta Mehta; Yatin Mehta; Mervyn Mer; Mark Nunnally; Simon Oczkowski; Tiffany Osborn; Elizabeth Papathanassoglou; Anders Perner; Michael Puskarich; Jason Roberts; William Schweickert; Maureen Seckel; Jonathan Sevransky; Charles L Sprung; Tobias Welte; Janice Zimmerman; Mitchell Levy Journal: Intensive Care Med Date: 2021-10-02 Impact factor: 17.440