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Meta-Analysis
. 2019 May 17;23(1):180.
doi: 10.1186/s13054-019-2465-y.

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

Youfeng Zhu  1 , Haiyan Yin  1 , Rui Zhang  1 , Xiaoling Ye  1 , Jianrui Wei  2
Affiliations
Meta-Analysis

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

Youfeng Zhu et al. Crit Care. .

Abstract

Background: The 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.

Method: We 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.

Results: Ten 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.

Conclusions: Our 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.

Keywords: High-flow nasal cannula; Mechanical ventilation; Oxygen therapy; Postextubation.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of the study selection process
Fig. 2
Fig. 2
Comparison of postextubation respiratory failure between the HFNC group and COT group
Fig. 3
Fig. 3
Comparison of PaO2 between the HFNC group and COT group
Fig. 4
Fig. 4
Comparison of respiratory rates between the HFNC group and COT group=
See this image and copyright information in PMC

Comment in

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