Si-Ming Lin1, Kai-Xiong Liu2, Zhi-Hong Lin3, Pei-Hong Lin3. 1. Department of Emergency Medicine, The First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou 350005, China. Electronic address: 565603150@qq.com. 2. Department of Respiratory Disease, The First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou 350005, China. Electronic address: lkxfpt@sina.com. 3. Department of Emergency Medicine, The First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou 350005, China.
Abstract
INTRODUCTION: To evaluate the efficacy of high-flow nasal cannula (HFNC) in the rate of intubation and mortality for patients with acute hypoxemic respiratory failure. METHODS: We searched Pubmed, EMBASE, and the Cochrane Library for relevant studies. Two reviewers extracted data and reviewed the quality of the studies independently. The primary outcome was the rate of intubation; secondary outcome was mortality in the hospital. Study-level data were pooled using a random-effects model when I2 was >50% or a fixed-effects model when I2 was <50%. RESULTS: Eight randomized controlled studies with a total of 1,818patients were considered. Pooled analysis showed that no statistically significant difference was found between groups regarding the rate of intubation (odds ratio [OR] = 0.79; 95% confidence interval [CI]: 0.60-1.04; P = 0.09; I2 = 36%) and no statistically significant difference was found between groups regarding hospital mortality (OR = 0.89; 95% CI: 0.62-127; P = 0.51; I2 = 47%). CONCLUSIONS: The use of HFNC showed a trend toward reduction in the intubation rate, which did not meet statistical significance, in patients with acute respiratory failure compared with conventional oxygen therapy (COT) and noninvasive ventilation (NIV). Moreover no difference in mortality. So, Large, well-designed, randomized, multi-center trials are needed to confirm the effects of HFNC in acute hypoxemic respiratory failure patients.
INTRODUCTION: To evaluate the efficacy of high-flow nasal cannula (HFNC) in the rate of intubation and mortality for patients with acute hypoxemic respiratory failure. METHODS: We searched Pubmed, EMBASE, and the Cochrane Library for relevant studies. Two reviewers extracted data and reviewed the quality of the studies independently. The primary outcome was the rate of intubation; secondary outcome was mortality in the hospital. Study-level data were pooled using a random-effects model when I2 was >50% or a fixed-effects model when I2 was <50%. RESULTS: Eight randomized controlled studies with a total of 1,818patients were considered. Pooled analysis showed that no statistically significant difference was found between groups regarding the rate of intubation (odds ratio [OR] = 0.79; 95% confidence interval [CI]: 0.60-1.04; P = 0.09; I2 = 36%) and no statistically significant difference was found between groups regarding hospital mortality (OR = 0.89; 95% CI: 0.62-127; P = 0.51; I2 = 47%). CONCLUSIONS: The use of HFNC showed a trend toward reduction in the intubation rate, which did not meet statistical significance, in patients with acute respiratory failure compared with conventional oxygen therapy (COT) and noninvasive ventilation (NIV). Moreover no difference in mortality. So, Large, well-designed, randomized, multi-center trials are needed to confirm the effects of HFNC in acute hypoxemic respiratory failurepatients.
Authors: Arianne K Baldomero; Anne C Melzer; Nancy Greer; Brittany N Majeski; Roderick MacDonald; Eric J Linskens; Timothy J Wilt Journal: Ann Intern Med Date: 2021-04-27 Impact factor: 25.391
Authors: Bruno L Ferreyro; Federico Angriman; Laveena Munshi; Lorenzo Del Sorbo; Niall D Ferguson; Bram Rochwerg; Michelle J Ryu; Refik Saskin; Hannah Wunsch; Bruno R da Costa; Damon C Scales Journal: Syst Rev Date: 2020-04-26