High-flow nasal cannula for acute exacerbation of chronic obstructive pulmonary disease: A systematic review and meta-analysis.
Heart & lung · 2020-12-22 · Meta-analysis
Abstract
BACKGROUND: The evidence for the safety of high-flow nasal cannula (HFNC) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients is conflicting. OBJECTIVES: To evaluate the intubation and mortality risks of HFNC compared to non-invasive ventilation (NIV) and conventional oxygen therapy (COT) for AECOPD patients. METHODS: A search of electronic databases was performed. Studies that used HFNC to treat AECOPD patients were identified. RESULTS: Seven RCTs and one observational study were included. There were no differences in intubation risk (risk ratio (RR) 0.94, 95% confidence interval (CI) 0.49 to 1.78, p = 0.84, very low certainty) and mortality risk (RR 0.91, 95% CI 0.46 to 1.79, p = 0.77, very low certainty) for HFNC compared with NIV. No data were available for intubation or mortality risk for HFNC compared with COT. CONCLUSION: For AECOPD patients, low-quality evidence indicates that HFNC does not increase intubation and mortality risks compared to NIV.
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Tags
CPAP & NIV · High-flow nasal oxygen · Mortality & survival · Other drugs · Oxygen
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