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Expert Review of Respiratory Medicine Volume 15, 2021 - Issue 10
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Meta-analysis

The effect of high flow nasal oxygen therapy in intensive care units: a systematic review and meta-analysis

Sujuan LiangNeurosurgery Center, Department of Neurotrauma and Neurocritical Care Medicine, The National Key Clinical Specialty, The Engineering Technology Research Center of Education, Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, ChinaCorrespondence[email protected]
,
Zhizheng LiuNeurosurgery Center, Department of Neurotrauma and Neurocritical Care Medicine, The National Key Clinical Specialty, The Engineering Technology Research Center of Education, Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, ChinaORCID Iconhttps://orcid.org/0000-0003-2361-493X
ORCID Icon,
Yueling QinNeurosurgery Center, Department of Neurotrauma and Neurocritical Care Medicine, The National Key Clinical Specialty, The Engineering Technology Research Center of Education, Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
&
Yue WuNeurosurgery Center, Department of Neurotrauma and Neurocritical Care Medicine, The National Key Clinical Specialty, The Engineering Technology Research Center of Education, Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
Pages 1335-1345 | Received 18 Sep 2020, Accepted 28 May 2021, Published online: 21 Jun 2021
 
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ABSTRACT

Background

High flow nasal oxygen (HFNO) therapy has been widely used in intensive care units (ICU); however, its efficacy remains inconclusive. This systematic review and meta-analysis aimed to compare the efficacy of HFNO therapy with th at of alternative noninvasive oxygen therapies such as conventional oxygen therapy (COT) and noninvasive ventilation (NIV) in ICU.

Methods

A Pubmed, Embase, Web of Science, Cochrane Library database search was performed in March 2020. Results: The meta-analysis ultimately included 17 clinical studies. Compared with the overall effect of COT and NIV, HFNO was associated with a low incidence of pneumonia (95% CI: 0.6–0.99, P = 0.04) and improvement in lowest pulse oxygen saturation (SpO₂) during oxygenation (95% CI: 0.02–1.61; P = 0.04). However, no differences were detected in the following outcomes: length of ICU stay, the rate of intubation or reintubation, mortality at day 28, hospital mortality, and SpO₂ at the end of oxygen therapy (all P > 0.05).

Conclusions

In adult patients in ICU, HFNO may improve oxygenation and decrease pneumonia rate without affecting the length of ICU stay, intubation or reintubation rate, mortality, and SpO₂ at the end of oxygen therapy.

Abbreviations

HFNO: high flow nasal oxygen; COT: conventional oxygen therapy; NIV: noninvasive ventilation; ICU: intensive care unit; SpO₂: pulse oxygen saturation; MD: Mean difference; OR: odds ratio; CI: confidence interval; PEEP: positive end-expiratory pressure

Data availability

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.

Ethics approval

This study does not contain any animal or human subjects and was exempted from institutional review board approval.

Declaration of interest

No potential conflict of interest was reported by the author(s).

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