Background: The effect of high-flow nasal cannula (HFNC) therapy in patients after planned extubation remains\ninconclusive. We aimed to perform a rigorous and comprehensive systematic meta-analysis to robustly quantify the\nbenefits of HFNC for patients after planned extubation by investigating postextubation respiratory failure and other\noutcomes.\nMethod: We searched MEDLINE, EMBASE, Web of Science, and the Cochrane Library from inception to August\n2018. Two researchers screened studies and collected the data independently. Randomized controlled trials (RCTs)\nand crossover studies were included. The main outcome was postextubation respiratory failure.\nResults: Ten studies (seven RCTs and three crossover studies; HFNC group: 856 patients; Conventional oxygen\ntherapy (COT) group: 852 patients) were included. Compared with COT, HFNC may significantly reduce\npostextubation respiratory failure (RR, 0.61; 95% CI, 0.41, 0.92; z = 2.38; P = 0.02) and respiratory rates (standardized\nmean 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,\n0.56; z = 2.23; P = 0.03). There were no significant differences in reintubation rate, length of ICU and hospital stay,\ncomfort score, PaCO2, mortality in ICU and hospital, and severe adverse events between HFNC and COT group.\nConclusions: Our meta-analysis demonstrated that compared with COT, HFNC may significantly reduce\npostextubation respiratory failure and respiratory rates, increase PaO2, and be safely administered in patients after\nplanned extubation. Further large-scale, multicenter studies are needed to confirm our results.
Loading....