Comparison of high-flow nasal cannula oxygenation and non-invasive ventilation for postoperative pediatric cardiac surgery: a meta-analysis

• Published in: BMC pulmonary medicine Vol. 24; no. 1; pp. 92 - 10
• Main Authors: Zhou, Si-Jia, Chen, Xiu-Hua, Liu, Ying-Ying, Chen, Qiang, Zheng, Yi-Rong, Zhang, Qi-Liang
• Format: Journal Article
• Language: English
• Published: London BioMed Central 21.02.2024; BioMed Central Ltd; BMC
• Subjects: Analysis; Artificial respiration; Bias; Cannula; Cardiac Surgical Procedures; Cardiovascular disease; Care and treatment; Child; Cohort analysis; Congenital diseases; Congenital heart disease; Congenital heart surgery; Critical Care Medicine; Extubation; Handbooks; Heart surgery; HFNC; Humans; Intensive; Internal Medicine; Intervention; Intubation, Intratracheal; Mechanical ventilation; Medical research; Medical Subject Headings-MeSH; Medicine; Medicine & Public Health; Meta; Meta-analysis; NIV; Noninvasive Ventilation; Oxygen Inhalation Therapy; Oxygen therapy; Oxygenation; Patient outcomes; Patients; Pediatric cardiology; Pediatric patients; Pediatrics; Pneumology/Respiratory System; Postoperative care; Randomized Controlled Trials as Topic; Respiration, Artificial; Respiratory Insufficiency - therapy; Statistical analysis; Ventilators; China; Congenital heart surgery; Meta; HFNC; NIV; Pediatric patients
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-024-02901-5

Objective To evaluate the efficacy of high-flow nasal cannula oxygenation (HFNC) versus non-invasive ventilation (NIV) in pediatric patients post-congenital heart surgery (CHS) through a meta-analysis. Methods A comprehensive literature search was conducted across the Chinese biomedical literature database, Vip database, CNKI, Wanfang, PubMed, Embase, Cochrane Library, and Web of Science until December 20, 2022. We selected RCTs or cohort studies that met inclusion criteria for a meta-analysis using RevMan 5.4 software. Results Our search yielded five publications, comprised of one randomized controlled trial and four cohort studies. Meta-analysis revealed a significant reduction in reintubation rates in children post-CHS treated with HFNC as compared to NIV [RR = 0.36, 95%CI(0.25 ~ 0.53), P  < 0.00001]. There was also a notable reduction in the duration of ICU stay [MD = -4.75, 95%CI (-9.38 ~ -0.12), P  = 0.04]. No statistically significant differences were observed between HFNC and NIV in terms of duration of mechanical ventilation, 24 h PaO 2 , and PaCO 2 post-treatment (P > 0.05). Furthermore, both groups showed no significant difference in the duration of extracorporeal circulation [MD = -8.27, 95%CI(-17.16 ~ 0.62), P  = 0.07]. Conclusions For pediatric patients post-CHS, HFNC appears to be more effective than NIV in reducing reintubation rates and shortening the CICU stay.