High‑flow nasal cannula is not more effective than conventional oxygen therapy for acute exacerbation of COPD with mild hypercapnia: we are not sure

Avdeev, S. N.; Yaroshetskiy, Andrey I.; Нуралиева, Г. С.; Avdeev, I. S.; Shmidt, Anna E.

doi:10.1186/s13054-022-04022-z

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…In spite of the aforementioned superiority, when compared with COT, HFNC presented no obvious advantage in the changes of PaCO 2 . This result is consistent with the dual role of HFNC in the acute exacerbation of COPD with mild or moderate-to-severe hypercapnia [ 22 ]. Setting a flow rate > 40 L/min with HFNC can improve the dynamic lung compliance [ 23 ].…”

Section: Discussionsupporting

confidence: 89%

Efficacy of high-flow nasal cannula in patients with acute heart failure: a systematic review and meta-analysis

Yan,

Lu,

Deng

et al. 2023

BMC Pulm Med

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Background Acute heart failure (AHF) is often associated with diffuse insufficiency and arterial hypoxemia, requiring respiratory support for rapid and effective correction. We aimed to compare the effects of high-flow nasal cannula(HFNC) with those of conventional oxygen therapy(COT) or non-invasive ventilation(NIV) on the prognosis of patients with AHF. Methods We performed the search using PubMed, Embase, Web of Science, MEDLINE, the Cochrane Library, CNKI, Wanfang, and VIP databases from the inception to August 31, 2023 for relevant studies in English and Chinese. We included controlled studies comparing HFNC with COT or NIV in patients with AHF. Primary outcomes included the intubation rate, respiratory rate (RR), heart rate (HR), and oxygenation status. Results From the 1288 original papers identified, 16 studies met the inclusion criteria, and 1333 patients were included. Compared with COT, HFNC reduced the intubation rate (odds ratio [OR]: 0.29, 95% CI: 0.14–0.58, P = 0.0005), RR (standardized mean difference [SMD]: -0.73 95% CI: -0.99 – -0.47, P < 0.00001) and HR (SMD: -0.88, 95% CI: -1.07 – -0.69, P < 0.00001), and hospital stay (SMD: -0.94, 95% CI: -1.76 – -0.12, P = 0.03), and increase arterial oxygen partial pressure (PaO2), (SMD: 0.88, 95% CI: 0.70–1.06, P < 0.00001) and oxygen saturation (SpO2 [%], SMD: 0.70, 95% CI: 0.34–1.06, P = 0.0001). Conclusions There were no significant differences in intubation rate, RR, HR, arterial blood gas parameters, and dyspnea scores between the HFNC and NIV groups. Compared with COT, HFNC effectively reduced the intubation rate and provided greater clinical benefits to patients with AHF. However, there was no significant difference in the clinical prognosis of patients with AHF between the HFNC and NIV groups. Trial registration PROSPERO (identifier: CRD42022365611).

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Section: Discussionsupporting

confidence: 89%

Efficacy of high-flow nasal cannula in patients with acute heart failure: a systematic review and meta-analysis

Yan,

Lu,

Deng

et al. 2023

BMC Pulm Med

View full text Add to dashboard Cite

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High-flow nasal oxygen therapy compared with conventional oxygen therapy in hospitalised patients with respiratory illness: a systematic review and meta-analysis

Seow,

Khor,

Khung

et al. 2024

BMJ Open Resp Res

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BackgroundHigh-flow nasal oxygen therapy (HFNO) is used in diverse hospital settings to treat patients with acute respiratory failure (ARF). This systematic review aims to summarise the evidence regarding any benefits HFNO therapy has compared with conventional oxygen therapy (COT) for patients with ARF.MethodsThree databases (Embase, Medline and CENTRAL) were searched on 22 March 2023 for studies evaluating HFNO compared with COT for the treatment of ARF, with the primary outcome being hospital mortality and secondary outcomes including (but not limited to) escalation to invasive mechanical ventilation (IMV) or non-invasive ventilation (NIV). Risk of bias was assessed using the Cochrane risk-of-bias tool (randomised controlled trials (RCTs)), ROBINS-I (non-randomised trials) or Newcastle-Ottawa Scale (observational studies). RCTs and observational studies were pooled together for primary analyses, and secondary analyses used RCT data only. Treatment effects were pooled using the random effects model.Results63 studies (26 RCTs, 13 cross-over and 24 observational studies) were included, with 10 230 participants. There was no significant difference in the primary outcome of hospital mortality (risk ratio, RR 1.08, 95% CI 0.93 to 1.26; p=0.29; 17 studies, n=5887) between HFNO and COT for all causes ARF. However, compared with COT, HFNO significantly reduced the overall need for escalation to IMV (RR 0.85, 95% CI 0.76 to 0.95 p=0.003; 39 studies, n=8932); and overall need for escalation to NIV (RR 0.70, 95% CI 0.50 to 0.98; p=0.04; 16 studies, n=3076). In subgroup analyses, when considering patients by illness types, those with acute-on-chronic respiratory failure who received HFNO compared with COT had a significant reduction in-hospital mortality (RR 0.58, 95% CI 0.37 to 0.91; p=0.02).DiscussionHFNO was superior to COT in reducing the need for escalation to both IMV and NIV but had no impact on the primary outcome of hospital mortality. These findings support recommendations that HFNO may be considered as first-line therapy for ARF.PROSPERO registration numberCRD42021264837.

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High‑flow nasal cannula is not more effective than conventional oxygen therapy for acute exacerbation of COPD with mild hypercapnia: we are not sure

Cited by 2 publications

References 4 publications

Efficacy of high-flow nasal cannula in patients with acute heart failure: a systematic review and meta-analysis

Efficacy of high-flow nasal cannula in patients with acute heart failure: a systematic review and meta-analysis

High-flow nasal oxygen therapy compared with conventional oxygen therapy in hospitalised patients with respiratory illness: a systematic review and meta-analysis

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