High-flow nasal cannula oxygen therapy vs conventional oxygen therapy in cardiac surgical patients: A meta-analysis

• Published in: Journal of critical care Vol. 38; pp. 123 - 128
• Main Authors: Zhu, Youfeng, Yin, Haiyan, Zhang, Rui, Wei, Jianrui
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2017; Elsevier Limited
• Subjects: Bias; Cannula; Cardiac surgery; Cardiac Surgical Procedures; China; Critical Care; Databases, Factual; Handbooks; Heart surgery; High-flow nasal cannula; Humans; Intensive Care Units; Intubation, Intratracheal - instrumentation; Intubation, Intratracheal - methods; Length of Stay; Meta-analysis; Oxygen; Oxygen Inhalation Therapy - instrumentation; Oxygen therapy; Quality; Respiratory support; Respiratory therapy; Studies; Ventilation; Ventilator Weaning; Cardiac surgery; Oxygen therapy; High-flow nasal cannula; Respiratory support
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2016.10.027

The use of high-flow nasal cannula (HFNC) for the treatment of many diseases has gained increasing popularity. In the present meta-analysis, we aimed to assess the efficacy and safety of HFNCs compared with conventional oxygen therapy (COT) in adult postextubation cardiac surgical patients. We reviewed the Embase, PubMed, Cochrane Central Register of Controlled Trials, Wanfang databases, and the China National Knowledge Infrastructure. Two investigators independently collected the data and assessed the quality of each study. RevMan 5.3 was used for the present meta-analysis. We included 495 adult postextubation cardiac surgical patients. There was no significant heterogeneity among the studies. Compared with COT, HFNCs were associated with a significant reduction in the escalation of respiratory support (risk ratio, 0.61; 95% confidence interval [CI], 0.46-0.82; z = 3.32, P < .001). There were no significant differences in the reintubation rate (risk ratio, 0.96; 95% CI, 0.04-24.84; z = 0.02, P = .98) or length of intensive care unit stay (weighted mean difference, 0.13; 95% CI, −0.88 to 7.92; z = 1.57, P = .12) between the 2 groups. No severe complications were reported in either group. The HFNC could reduce the need for escalation of respiratory support compared with COT, and it could be safely administered in adult postextubation cardiac surgical patients.