High-flow oxygen therapy in immunocompromised patients with acute respiratory failure: A review and meta-analysis

• Published in: Journal of critical care Vol. 43; pp. 300 - 305
• Main Authors: Huang, Hui-Bin, Peng, Jin-Min, Weng, Li, Liu, Guang-Yun, Du, Bin
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2018; Elsevier Limited
• Subjects: Acute respiratory failure; Confidence intervals; Evidence-based medicine; High-flow nasal cannula oxygen therapy; Immune system; Immunocompromised patients; Intensive care; Meta-analysis; Oxygen therapy; Respiratory distress syndrome; Respiratory failure; RR; High-flow nasal cannula oxygen therapy; IQR; CIs; Immunocompromised patients; Meta-analysis; SD; HFNC; ARF; RCTs; MD; Acute respiratory failure; ICU; NIV
• ISSN: 0883-9441; 1557-8615; 1557-8615
• DOI: 10.1016/j.jcrc.2017.09.176

Acute respiratory failure remains a common hazardous complication in immunocompromised patients and is associated with increased mortality rates when endotracheal intubation is need. We aimed to evaluate the effect of high-flow nasal cannula oxygen therapy (HFNC) compared with other oxygen technique for this patient population. We searched Cochrane library, Embase, PubMed databases before Aug. 15, 2017 for eligible articles. A meta-analysis was performed for measuring short-term mortality (defined as ICU, hospital or 28-days mortality) and intubation rate as the primary outcomes, and length of stay in ICU as the secondary outcome. We included seven studies involving 667 patients. Use of HFNC was significantly association with a reduction in short-term mortality (RR 0.66; 95% CI, 0.52 to 0.84, p=0.0007) and intubation rate (RR 0.76, 95% CI 0.64 to 0.90; p=0.002). In addition, HFNC did not significant increase length of stay in ICU (MD 0.15days; 95% CI, −2.08 to 2.39; p=0.89). The results of current meta-analysis suggest that use of HFNC significantly improve outcomes of acute respiratory failure in immunocompromised patients. Owing to the quality of the included studies, further adequately powered randomized controlled trials are needed to confirm our results. •Mortality remains high in immunocompromised patients with acute respiratory failure.•HFNC was compared with other oxygen techniques for this patient population.•HFNC significantly improve outcome of ARF in immunocompromised patients.