High flow nasal cannula compared with conventional oxygen therapy for acute hypoxemic respiratory failure: a systematic review and meta-analysis View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-03-19

AUTHORS

B. Rochwerg, D. Granton, D. X. Wang, Y. Helviz, S. Einav, J. P. Frat, A. Mekontso-Dessap, A. Schreiber, E. Azoulay, A. Mercat, A. Demoule, V. Lemiale, A. Pesenti, E. D. Riviello, T. Mauri, J. Mancebo, L. Brochard, K. Burns

ABSTRACT

BACKGROUND: This systematic review and meta-analysis summarizes the safety and efficacy of high flow nasal cannula (HFNC) in patients with acute hypoxemic respiratory failure. METHODS: We performed a comprehensive search of MEDLINE, EMBASE, and Web of Science. We identified randomized controlled trials that compared HFNC to conventional oxygen therapy. We pooled data and report summary estimates of effect using relative risk for dichotomous outcomes and mean difference or standardized mean difference for continuous outcomes, with 95% confidence intervals. We assessed risk of bias of included studies using the Cochrane tool and certainty in pooled effect estimates using GRADE methods. RESULTS: We included 9 RCTs (n = 2093 patients). We found no difference in mortality in patients treated with HFNC (relative risk [RR] 0.94, 95% confidence interval [CI] 0.67-1.31, moderate certainty) compared to conventional oxygen therapy. We found a decreased risk of requiring intubation (RR 0.85, 95% CI 0.74-0.99) or escalation of oxygen therapy (defined as crossover to HFNC in the control group, or initiation of non-invasive ventilation or invasive mechanical ventilation in either group) favouring HFNC-treated patients (RR 0.71, 95% CI 0.51-0.98), although certainty in both outcomes was low due to imprecision and issues related to risk of bias. HFNC had no effect on intensive care unit length of stay (mean difference [MD] 1.38 days more, 95% CI 0.90 days fewer to 3.66 days more, low certainty), hospital length of stay (MD 0.85 days fewer, 95% CI 2.07 days fewer to 0.37 days more, moderate certainty), patient reported comfort (SMD 0.12 lower, 95% CI 0.61 lower to 0.37 higher, very low certainty) or patient reported dyspnea (standardized mean difference [SMD] 0.16 lower, 95% CI 1.10 lower to 1.42 higher, low certainty). Complications of treatment were variably reported amongst included studies, but little harm was associated with HFNC use. CONCLUSION: In patients with acute hypoxemic respiratory failure, HFNC may decrease the need for tracheal intubation without impacting mortality. More... »

PAGES

1-10

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00134-019-05590-5

DOI

http://dx.doi.org/10.1007/s00134-019-05590-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1112860906

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30888444


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Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

JSON-LD is a popular format for linked data which is fully compatible with JSON.

curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1007/s00134-019-05590-5'

N-Triples is a line-based linked data format ideal for batch operations.

curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1007/s00134-019-05590-5'

Turtle is a human-readable linked data format.

curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1007/s00134-019-05590-5'

RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1007/s00134-019-05590-5'


 

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294 Università degli Studi di Milano, Dipartimento di Fisopatologia Medico-Chirurgica e dei Trapianti, Milan, Italy
295 rdf:type schema:Organization
296 https://www.grid.ac/institutes/grid.50550.35 schema:alternateName Assistance Publique -Hopitaux De Paris
297 schema:name Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne Université, INSERM, UMRS1158, Paris, France
298 Service de Pneumologie et Réanimation Médicale du Département R3S, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Paris, France
299 rdf:type schema:Organization
300 https://www.grid.ac/institutes/grid.9619.7 schema:alternateName Hebrew University of Jerusalem
301 schema:name Faculty of Medicine, Hebrew University, Jerusalem, Israel
302 General Intensive Care Unit, Shaare Zedek Medical Center, Jerusalem, Israel
303 rdf:type schema:Organization
 




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