High-flow nasal cannula in adults with acute respiratory failure and after extubation: a systematic review and meta-analysis

Background High-flow nasal cannula (HFNC) can be used as an initial support strategy for patients with acute respiratory failure (ARF) and after extubation. However, no clear evidence exists to support or oppose HFNC use in clinical practice. We summarized the effects of HFNC, compared to convention...
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Gespeichert in:

Autor*in:	Xu, Zhiheng [verfasserIn] Li, Yimin Zhou, Jianmeng Li, Xi Huang, Yongbo Liu, Xiaoqing Burns, Karen E. A. Zhong, Nanshan Zhang, Haibo

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2018

Schlagwörter:	Conventional oxygen therapy Noninvasive ventilation Extubation

Anmerkung:	© The Author(s). 2018

Übergeordnetes Werk:	Enthalten in: Respiratory research - London : BioMed Central, 2001, 19(2018), 1 vom: 16. Okt.
Übergeordnetes Werk:	volume:19 ; year:2018 ; number:1 ; day:16 ; month:10

Links:	Volltext

DOI / URN:	10.1186/s12931-018-0908-7

Katalog-ID:	SPR028526813

Internformat


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100	1		\|a Xu, Zhiheng \|e verfasserin \|4 aut
245	1	0	\|a High-flow nasal cannula in adults with acute respiratory failure and after extubation: a systematic review and meta-analysis
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520			\|a Background High-flow nasal cannula (HFNC) can be used as an initial support strategy for patients with acute respiratory failure (ARF) and after extubation. However, no clear evidence exists to support or oppose HFNC use in clinical practice. We summarized the effects of HFNC, compared to conventional oxygen therapy (COT) and noninvasive ventilation (NIV), on important outcomes including treatment failure and intubation/reintubation rates in adult patients with ARF and after extubation. Methods We searched 4 electronic databases (Pubmed, EMBASE, Scopus, and Web of Science) to identify randomized controlled trials (RCTs) comparing the effects of HFNC with either COT or NIV on rates of 1) treatment failure and 2) intubation/reintubation in adult critically ill patients. Results We identified 18 RCTs (n = 4251 patients) in pooled analyses. As a primary mode of support, HFNC treatment reduced the risk of treatment failure [Odds Ratio (OR) 0.65; 95% confidence interval (CI) 0.43–0.98; p = 0.04; $ I^{2} $ = 32%] but had no effect on preventing intubation (OR, 0.74; 95%CI 0.45–1.21; p = 0.23; $ I^{2} $ = 0%) compared to COT. When used after extubation, HFNC (vs. COT) treatment significantly decreased reintubation rate (OR 0.46; 95%CI 0.33–0.63; p < 0.00001; $ I^{2} $ = 30%) and extubation failure (OR 0.43; 95%CI 0.25–0.73; p = 0.002; $ I^{2} $ = 66%). Compared to NIV, HFNC significantly reduced intubation rate (OR 0.57; 95%CI 0.36–0.92; p = 0.02; $ I^{2} $ = 0%) when used as initial support, but did no favorably impact clinical outcomes post extubation in few trials. Conclusions HFNC was superior to COT in reducing treatment failure when used as a primary support strategy and in reducing rates of extubation failure and reintubation when used after extubation. In few trials, HFNC reduced intubation rate compared to NIV when used as initial support but demonstrated no beneficial effects after extubation.
650		4	\|a Conventional oxygen therapy \|7 (dpeaa)DE-He213
650		4	\|a Noninvasive ventilation \|7 (dpeaa)DE-He213
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700	1		\|a Liu, Xiaoqing \|4 aut
700	1		\|a Burns, Karen E. A. \|4 aut
700	1		\|a Zhong, Nanshan \|4 aut
700	1		\|a Zhang, Haibo \|4 aut
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912			\|a GBV_ILN_4700
951			\|a AR
952			\|d 19 \|j 2018 \|e 1 \|b 16 \|c 10

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allfields	10.1186/s12931-018-0908-7 doi (DE-627)SPR028526813 (SPR)s12931-018-0908-7-e DE-627 ger DE-627 rakwb eng Xu, Zhiheng verfasserin aut High-flow nasal cannula in adults with acute respiratory failure and after extubation: a systematic review and meta-analysis 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2018 Background High-flow nasal cannula (HFNC) can be used as an initial support strategy for patients with acute respiratory failure (ARF) and after extubation. However, no clear evidence exists to support or oppose HFNC use in clinical practice. We summarized the effects of HFNC, compared to conventional oxygen therapy (COT) and noninvasive ventilation (NIV), on important outcomes including treatment failure and intubation/reintubation rates in adult patients with ARF and after extubation. Methods We searched 4 electronic databases (Pubmed, EMBASE, Scopus, and Web of Science) to identify randomized controlled trials (RCTs) comparing the effects of HFNC with either COT or NIV on rates of 1) treatment failure and 2) intubation/reintubation in adult critically ill patients. Results We identified 18 RCTs (n = 4251 patients) in pooled analyses. As a primary mode of support, HFNC treatment reduced the risk of treatment failure [Odds Ratio (OR) 0.65; 95% confidence interval (CI) 0.43–0.98; p = 0.04; $ I^{2} $ = 32%] but had no effect on preventing intubation (OR, 0.74; 95%CI 0.45–1.21; p = 0.23; $ I^{2} $ = 0%) compared to COT. When used after extubation, HFNC (vs. COT) treatment significantly decreased reintubation rate (OR 0.46; 95%CI 0.33–0.63; p < 0.00001; $ I^{2} $ = 30%) and extubation failure (OR 0.43; 95%CI 0.25–0.73; p = 0.002; $ I^{2} $ = 66%). Compared to NIV, HFNC significantly reduced intubation rate (OR 0.57; 95%CI 0.36–0.92; p = 0.02; $ I^{2} $ = 0%) when used as initial support, but did no favorably impact clinical outcomes post extubation in few trials. Conclusions HFNC was superior to COT in reducing treatment failure when used as a primary support strategy and in reducing rates of extubation failure and reintubation when used after extubation. In few trials, HFNC reduced intubation rate compared to NIV when used as initial support but demonstrated no beneficial effects after extubation. Conventional oxygen therapy (dpeaa)DE-He213 Noninvasive ventilation (dpeaa)DE-He213 Extubation (dpeaa)DE-He213 Li, Yimin aut Zhou, Jianmeng aut Li, Xi aut Huang, Yongbo aut Liu, Xiaoqing aut Burns, Karen E. A. aut Zhong, Nanshan aut Zhang, Haibo aut Enthalten in Respiratory research London : BioMed Central, 2001 19(2018), 1 vom: 16. Okt. (DE-627)326646485 (DE-600)2041675-1 1465-993X nnns volume:19 year:2018 number:1 day:16 month:10 https://dx.doi.org/10.1186/s12931-018-0908-7 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2018 1 16 10
spelling	10.1186/s12931-018-0908-7 doi (DE-627)SPR028526813 (SPR)s12931-018-0908-7-e DE-627 ger DE-627 rakwb eng Xu, Zhiheng verfasserin aut High-flow nasal cannula in adults with acute respiratory failure and after extubation: a systematic review and meta-analysis 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2018 Background High-flow nasal cannula (HFNC) can be used as an initial support strategy for patients with acute respiratory failure (ARF) and after extubation. However, no clear evidence exists to support or oppose HFNC use in clinical practice. We summarized the effects of HFNC, compared to conventional oxygen therapy (COT) and noninvasive ventilation (NIV), on important outcomes including treatment failure and intubation/reintubation rates in adult patients with ARF and after extubation. Methods We searched 4 electronic databases (Pubmed, EMBASE, Scopus, and Web of Science) to identify randomized controlled trials (RCTs) comparing the effects of HFNC with either COT or NIV on rates of 1) treatment failure and 2) intubation/reintubation in adult critically ill patients. Results We identified 18 RCTs (n = 4251 patients) in pooled analyses. As a primary mode of support, HFNC treatment reduced the risk of treatment failure [Odds Ratio (OR) 0.65; 95% confidence interval (CI) 0.43–0.98; p = 0.04; $ I^{2} $ = 32%] but had no effect on preventing intubation (OR, 0.74; 95%CI 0.45–1.21; p = 0.23; $ I^{2} $ = 0%) compared to COT. When used after extubation, HFNC (vs. COT) treatment significantly decreased reintubation rate (OR 0.46; 95%CI 0.33–0.63; p < 0.00001; $ I^{2} $ = 30%) and extubation failure (OR 0.43; 95%CI 0.25–0.73; p = 0.002; $ I^{2} $ = 66%). Compared to NIV, HFNC significantly reduced intubation rate (OR 0.57; 95%CI 0.36–0.92; p = 0.02; $ I^{2} $ = 0%) when used as initial support, but did no favorably impact clinical outcomes post extubation in few trials. Conclusions HFNC was superior to COT in reducing treatment failure when used as a primary support strategy and in reducing rates of extubation failure and reintubation when used after extubation. In few trials, HFNC reduced intubation rate compared to NIV when used as initial support but demonstrated no beneficial effects after extubation. Conventional oxygen therapy (dpeaa)DE-He213 Noninvasive ventilation (dpeaa)DE-He213 Extubation (dpeaa)DE-He213 Li, Yimin aut Zhou, Jianmeng aut Li, Xi aut Huang, Yongbo aut Liu, Xiaoqing aut Burns, Karen E. A. aut Zhong, Nanshan aut Zhang, Haibo aut Enthalten in Respiratory research London : BioMed Central, 2001 19(2018), 1 vom: 16. Okt. (DE-627)326646485 (DE-600)2041675-1 1465-993X nnns volume:19 year:2018 number:1 day:16 month:10 https://dx.doi.org/10.1186/s12931-018-0908-7 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2018 1 16 10
allfields_unstemmed	10.1186/s12931-018-0908-7 doi (DE-627)SPR028526813 (SPR)s12931-018-0908-7-e DE-627 ger DE-627 rakwb eng Xu, Zhiheng verfasserin aut High-flow nasal cannula in adults with acute respiratory failure and after extubation: a systematic review and meta-analysis 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2018 Background High-flow nasal cannula (HFNC) can be used as an initial support strategy for patients with acute respiratory failure (ARF) and after extubation. However, no clear evidence exists to support or oppose HFNC use in clinical practice. We summarized the effects of HFNC, compared to conventional oxygen therapy (COT) and noninvasive ventilation (NIV), on important outcomes including treatment failure and intubation/reintubation rates in adult patients with ARF and after extubation. Methods We searched 4 electronic databases (Pubmed, EMBASE, Scopus, and Web of Science) to identify randomized controlled trials (RCTs) comparing the effects of HFNC with either COT or NIV on rates of 1) treatment failure and 2) intubation/reintubation in adult critically ill patients. Results We identified 18 RCTs (n = 4251 patients) in pooled analyses. As a primary mode of support, HFNC treatment reduced the risk of treatment failure [Odds Ratio (OR) 0.65; 95% confidence interval (CI) 0.43–0.98; p = 0.04; $ I^{2} $ = 32%] but had no effect on preventing intubation (OR, 0.74; 95%CI 0.45–1.21; p = 0.23; $ I^{2} $ = 0%) compared to COT. When used after extubation, HFNC (vs. COT) treatment significantly decreased reintubation rate (OR 0.46; 95%CI 0.33–0.63; p < 0.00001; $ I^{2} $ = 30%) and extubation failure (OR 0.43; 95%CI 0.25–0.73; p = 0.002; $ I^{2} $ = 66%). Compared to NIV, HFNC significantly reduced intubation rate (OR 0.57; 95%CI 0.36–0.92; p = 0.02; $ I^{2} $ = 0%) when used as initial support, but did no favorably impact clinical outcomes post extubation in few trials. Conclusions HFNC was superior to COT in reducing treatment failure when used as a primary support strategy and in reducing rates of extubation failure and reintubation when used after extubation. In few trials, HFNC reduced intubation rate compared to NIV when used as initial support but demonstrated no beneficial effects after extubation. Conventional oxygen therapy (dpeaa)DE-He213 Noninvasive ventilation (dpeaa)DE-He213 Extubation (dpeaa)DE-He213 Li, Yimin aut Zhou, Jianmeng aut Li, Xi aut Huang, Yongbo aut Liu, Xiaoqing aut Burns, Karen E. A. aut Zhong, Nanshan aut Zhang, Haibo aut Enthalten in Respiratory research London : BioMed Central, 2001 19(2018), 1 vom: 16. Okt. (DE-627)326646485 (DE-600)2041675-1 1465-993X nnns volume:19 year:2018 number:1 day:16 month:10 https://dx.doi.org/10.1186/s12931-018-0908-7 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2018 1 16 10
allfieldsGer	10.1186/s12931-018-0908-7 doi (DE-627)SPR028526813 (SPR)s12931-018-0908-7-e DE-627 ger DE-627 rakwb eng Xu, Zhiheng verfasserin aut High-flow nasal cannula in adults with acute respiratory failure and after extubation: a systematic review and meta-analysis 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2018 Background High-flow nasal cannula (HFNC) can be used as an initial support strategy for patients with acute respiratory failure (ARF) and after extubation. However, no clear evidence exists to support or oppose HFNC use in clinical practice. We summarized the effects of HFNC, compared to conventional oxygen therapy (COT) and noninvasive ventilation (NIV), on important outcomes including treatment failure and intubation/reintubation rates in adult patients with ARF and after extubation. Methods We searched 4 electronic databases (Pubmed, EMBASE, Scopus, and Web of Science) to identify randomized controlled trials (RCTs) comparing the effects of HFNC with either COT or NIV on rates of 1) treatment failure and 2) intubation/reintubation in adult critically ill patients. Results We identified 18 RCTs (n = 4251 patients) in pooled analyses. As a primary mode of support, HFNC treatment reduced the risk of treatment failure [Odds Ratio (OR) 0.65; 95% confidence interval (CI) 0.43–0.98; p = 0.04; $ I^{2} $ = 32%] but had no effect on preventing intubation (OR, 0.74; 95%CI 0.45–1.21; p = 0.23; $ I^{2} $ = 0%) compared to COT. When used after extubation, HFNC (vs. COT) treatment significantly decreased reintubation rate (OR 0.46; 95%CI 0.33–0.63; p < 0.00001; $ I^{2} $ = 30%) and extubation failure (OR 0.43; 95%CI 0.25–0.73; p = 0.002; $ I^{2} $ = 66%). Compared to NIV, HFNC significantly reduced intubation rate (OR 0.57; 95%CI 0.36–0.92; p = 0.02; $ I^{2} $ = 0%) when used as initial support, but did no favorably impact clinical outcomes post extubation in few trials. Conclusions HFNC was superior to COT in reducing treatment failure when used as a primary support strategy and in reducing rates of extubation failure and reintubation when used after extubation. In few trials, HFNC reduced intubation rate compared to NIV when used as initial support but demonstrated no beneficial effects after extubation. Conventional oxygen therapy (dpeaa)DE-He213 Noninvasive ventilation (dpeaa)DE-He213 Extubation (dpeaa)DE-He213 Li, Yimin aut Zhou, Jianmeng aut Li, Xi aut Huang, Yongbo aut Liu, Xiaoqing aut Burns, Karen E. A. aut Zhong, Nanshan aut Zhang, Haibo aut Enthalten in Respiratory research London : BioMed Central, 2001 19(2018), 1 vom: 16. Okt. (DE-627)326646485 (DE-600)2041675-1 1465-993X nnns volume:19 year:2018 number:1 day:16 month:10 https://dx.doi.org/10.1186/s12931-018-0908-7 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2018 1 16 10
allfieldsSound	10.1186/s12931-018-0908-7 doi (DE-627)SPR028526813 (SPR)s12931-018-0908-7-e DE-627 ger DE-627 rakwb eng Xu, Zhiheng verfasserin aut High-flow nasal cannula in adults with acute respiratory failure and after extubation: a systematic review and meta-analysis 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2018 Background High-flow nasal cannula (HFNC) can be used as an initial support strategy for patients with acute respiratory failure (ARF) and after extubation. However, no clear evidence exists to support or oppose HFNC use in clinical practice. We summarized the effects of HFNC, compared to conventional oxygen therapy (COT) and noninvasive ventilation (NIV), on important outcomes including treatment failure and intubation/reintubation rates in adult patients with ARF and after extubation. Methods We searched 4 electronic databases (Pubmed, EMBASE, Scopus, and Web of Science) to identify randomized controlled trials (RCTs) comparing the effects of HFNC with either COT or NIV on rates of 1) treatment failure and 2) intubation/reintubation in adult critically ill patients. Results We identified 18 RCTs (n = 4251 patients) in pooled analyses. As a primary mode of support, HFNC treatment reduced the risk of treatment failure [Odds Ratio (OR) 0.65; 95% confidence interval (CI) 0.43–0.98; p = 0.04; $ I^{2} $ = 32%] but had no effect on preventing intubation (OR, 0.74; 95%CI 0.45–1.21; p = 0.23; $ I^{2} $ = 0%) compared to COT. When used after extubation, HFNC (vs. COT) treatment significantly decreased reintubation rate (OR 0.46; 95%CI 0.33–0.63; p < 0.00001; $ I^{2} $ = 30%) and extubation failure (OR 0.43; 95%CI 0.25–0.73; p = 0.002; $ I^{2} $ = 66%). Compared to NIV, HFNC significantly reduced intubation rate (OR 0.57; 95%CI 0.36–0.92; p = 0.02; $ I^{2} $ = 0%) when used as initial support, but did no favorably impact clinical outcomes post extubation in few trials. Conclusions HFNC was superior to COT in reducing treatment failure when used as a primary support strategy and in reducing rates of extubation failure and reintubation when used after extubation. In few trials, HFNC reduced intubation rate compared to NIV when used as initial support but demonstrated no beneficial effects after extubation. Conventional oxygen therapy (dpeaa)DE-He213 Noninvasive ventilation (dpeaa)DE-He213 Extubation (dpeaa)DE-He213 Li, Yimin aut Zhou, Jianmeng aut Li, Xi aut Huang, Yongbo aut Liu, Xiaoqing aut Burns, Karen E. A. aut Zhong, Nanshan aut Zhang, Haibo aut Enthalten in Respiratory research London : BioMed Central, 2001 19(2018), 1 vom: 16. Okt. (DE-627)326646485 (DE-600)2041675-1 1465-993X nnns volume:19 year:2018 number:1 day:16 month:10 https://dx.doi.org/10.1186/s12931-018-0908-7 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2018 1 16 10
language	English
source	Enthalten in Respiratory research 19(2018), 1 vom: 16. Okt. volume:19 year:2018 number:1 day:16 month:10
sourceStr	Enthalten in Respiratory research 19(2018), 1 vom: 16. Okt. volume:19 year:2018 number:1 day:16 month:10
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Conventional oxygen therapy Noninvasive ventilation Extubation
isfreeaccess_bool	true
container_title	Respiratory research
authorswithroles_txt_mv	Xu, Zhiheng @@aut@@ Li, Yimin @@aut@@ Zhou, Jianmeng @@aut@@ Li, Xi @@aut@@ Huang, Yongbo @@aut@@ Liu, Xiaoqing @@aut@@ Burns, Karen E. A. @@aut@@ Zhong, Nanshan @@aut@@ Zhang, Haibo @@aut@@
publishDateDaySort_date	2018-10-16T00:00:00Z
hierarchy_top_id	326646485
id	SPR028526813
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR028526813</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230519192254.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201007s2018 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1186/s12931-018-0908-7</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR028526813</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s12931-018-0908-7-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Xu, Zhiheng</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">High-flow nasal cannula in adults with acute respiratory failure and after extubation: a systematic review and meta-analysis</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2018</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© The Author(s). 2018</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background High-flow nasal cannula (HFNC) can be used as an initial support strategy for patients with acute respiratory failure (ARF) and after extubation. However, no clear evidence exists to support or oppose HFNC use in clinical practice. We summarized the effects of HFNC, compared to conventional oxygen therapy (COT) and noninvasive ventilation (NIV), on important outcomes including treatment failure and intubation/reintubation rates in adult patients with ARF and after extubation. Methods We searched 4 electronic databases (Pubmed, EMBASE, Scopus, and Web of Science) to identify randomized controlled trials (RCTs) comparing the effects of HFNC with either COT or NIV on rates of 1) treatment failure and 2) intubation/reintubation in adult critically ill patients. Results We identified 18 RCTs (n = 4251 patients) in pooled analyses. As a primary mode of support, HFNC treatment reduced the risk of treatment failure [Odds Ratio (OR) 0.65; 95% confidence interval (CI) 0.43–0.98; p = 0.04; $ I^{2} $ = 32%] but had no effect on preventing intubation (OR, 0.74; 95%CI 0.45–1.21; p = 0.23; $ I^{2} $ = 0%) compared to COT. When used after extubation, HFNC (vs. COT) treatment significantly decreased reintubation rate (OR 0.46; 95%CI 0.33–0.63; p < 0.00001; $ I^{2} $ = 30%) and extubation failure (OR 0.43; 95%CI 0.25–0.73; p = 0.002; $ I^{2} $ = 66%). Compared to NIV, HFNC significantly reduced intubation rate (OR 0.57; 95%CI 0.36–0.92; p = 0.02; $ I^{2} $ = 0%) when used as initial support, but did no favorably impact clinical outcomes post extubation in few trials. Conclusions HFNC was superior to COT in reducing treatment failure when used as a primary support strategy and in reducing rates of extubation failure and reintubation when used after extubation. 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author	Xu, Zhiheng
spellingShingle	Xu, Zhiheng misc Conventional oxygen therapy misc Noninvasive ventilation misc Extubation High-flow nasal cannula in adults with acute respiratory failure and after extubation: a systematic review and meta-analysis
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topic_title	High-flow nasal cannula in adults with acute respiratory failure and after extubation: a systematic review and meta-analysis Conventional oxygen therapy (dpeaa)DE-He213 Noninvasive ventilation (dpeaa)DE-He213 Extubation (dpeaa)DE-He213
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title	High-flow nasal cannula in adults with acute respiratory failure and after extubation: a systematic review and meta-analysis
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title_full	High-flow nasal cannula in adults with acute respiratory failure and after extubation: a systematic review and meta-analysis
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author_browse	Xu, Zhiheng Li, Yimin Zhou, Jianmeng Li, Xi Huang, Yongbo Liu, Xiaoqing Burns, Karen E. A. Zhong, Nanshan Zhang, Haibo
container_volume	19
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doi_str_mv	10.1186/s12931-018-0908-7
title_sort	high-flow nasal cannula in adults with acute respiratory failure and after extubation: a systematic review and meta-analysis
title_auth	High-flow nasal cannula in adults with acute respiratory failure and after extubation: a systematic review and meta-analysis
abstract	Background High-flow nasal cannula (HFNC) can be used as an initial support strategy for patients with acute respiratory failure (ARF) and after extubation. However, no clear evidence exists to support or oppose HFNC use in clinical practice. We summarized the effects of HFNC, compared to conventional oxygen therapy (COT) and noninvasive ventilation (NIV), on important outcomes including treatment failure and intubation/reintubation rates in adult patients with ARF and after extubation. Methods We searched 4 electronic databases (Pubmed, EMBASE, Scopus, and Web of Science) to identify randomized controlled trials (RCTs) comparing the effects of HFNC with either COT or NIV on rates of 1) treatment failure and 2) intubation/reintubation in adult critically ill patients. Results We identified 18 RCTs (n = 4251 patients) in pooled analyses. As a primary mode of support, HFNC treatment reduced the risk of treatment failure [Odds Ratio (OR) 0.65; 95% confidence interval (CI) 0.43–0.98; p = 0.04; $ I^{2} $ = 32%] but had no effect on preventing intubation (OR, 0.74; 95%CI 0.45–1.21; p = 0.23; $ I^{2} $ = 0%) compared to COT. When used after extubation, HFNC (vs. COT) treatment significantly decreased reintubation rate (OR 0.46; 95%CI 0.33–0.63; p < 0.00001; $ I^{2} $ = 30%) and extubation failure (OR 0.43; 95%CI 0.25–0.73; p = 0.002; $ I^{2} $ = 66%). Compared to NIV, HFNC significantly reduced intubation rate (OR 0.57; 95%CI 0.36–0.92; p = 0.02; $ I^{2} $ = 0%) when used as initial support, but did no favorably impact clinical outcomes post extubation in few trials. Conclusions HFNC was superior to COT in reducing treatment failure when used as a primary support strategy and in reducing rates of extubation failure and reintubation when used after extubation. In few trials, HFNC reduced intubation rate compared to NIV when used as initial support but demonstrated no beneficial effects after extubation. © The Author(s). 2018
abstractGer	Background High-flow nasal cannula (HFNC) can be used as an initial support strategy for patients with acute respiratory failure (ARF) and after extubation. However, no clear evidence exists to support or oppose HFNC use in clinical practice. We summarized the effects of HFNC, compared to conventional oxygen therapy (COT) and noninvasive ventilation (NIV), on important outcomes including treatment failure and intubation/reintubation rates in adult patients with ARF and after extubation. Methods We searched 4 electronic databases (Pubmed, EMBASE, Scopus, and Web of Science) to identify randomized controlled trials (RCTs) comparing the effects of HFNC with either COT or NIV on rates of 1) treatment failure and 2) intubation/reintubation in adult critically ill patients. Results We identified 18 RCTs (n = 4251 patients) in pooled analyses. As a primary mode of support, HFNC treatment reduced the risk of treatment failure [Odds Ratio (OR) 0.65; 95% confidence interval (CI) 0.43–0.98; p = 0.04; $ I^{2} $ = 32%] but had no effect on preventing intubation (OR, 0.74; 95%CI 0.45–1.21; p = 0.23; $ I^{2} $ = 0%) compared to COT. When used after extubation, HFNC (vs. COT) treatment significantly decreased reintubation rate (OR 0.46; 95%CI 0.33–0.63; p < 0.00001; $ I^{2} $ = 30%) and extubation failure (OR 0.43; 95%CI 0.25–0.73; p = 0.002; $ I^{2} $ = 66%). Compared to NIV, HFNC significantly reduced intubation rate (OR 0.57; 95%CI 0.36–0.92; p = 0.02; $ I^{2} $ = 0%) when used as initial support, but did no favorably impact clinical outcomes post extubation in few trials. Conclusions HFNC was superior to COT in reducing treatment failure when used as a primary support strategy and in reducing rates of extubation failure and reintubation when used after extubation. In few trials, HFNC reduced intubation rate compared to NIV when used as initial support but demonstrated no beneficial effects after extubation. © The Author(s). 2018
abstract_unstemmed	Background High-flow nasal cannula (HFNC) can be used as an initial support strategy for patients with acute respiratory failure (ARF) and after extubation. However, no clear evidence exists to support or oppose HFNC use in clinical practice. We summarized the effects of HFNC, compared to conventional oxygen therapy (COT) and noninvasive ventilation (NIV), on important outcomes including treatment failure and intubation/reintubation rates in adult patients with ARF and after extubation. Methods We searched 4 electronic databases (Pubmed, EMBASE, Scopus, and Web of Science) to identify randomized controlled trials (RCTs) comparing the effects of HFNC with either COT or NIV on rates of 1) treatment failure and 2) intubation/reintubation in adult critically ill patients. Results We identified 18 RCTs (n = 4251 patients) in pooled analyses. As a primary mode of support, HFNC treatment reduced the risk of treatment failure [Odds Ratio (OR) 0.65; 95% confidence interval (CI) 0.43–0.98; p = 0.04; $ I^{2} $ = 32%] but had no effect on preventing intubation (OR, 0.74; 95%CI 0.45–1.21; p = 0.23; $ I^{2} $ = 0%) compared to COT. When used after extubation, HFNC (vs. COT) treatment significantly decreased reintubation rate (OR 0.46; 95%CI 0.33–0.63; p < 0.00001; $ I^{2} $ = 30%) and extubation failure (OR 0.43; 95%CI 0.25–0.73; p = 0.002; $ I^{2} $ = 66%). Compared to NIV, HFNC significantly reduced intubation rate (OR 0.57; 95%CI 0.36–0.92; p = 0.02; $ I^{2} $ = 0%) when used as initial support, but did no favorably impact clinical outcomes post extubation in few trials. Conclusions HFNC was superior to COT in reducing treatment failure when used as a primary support strategy and in reducing rates of extubation failure and reintubation when used after extubation. In few trials, HFNC reduced intubation rate compared to NIV when used as initial support but demonstrated no beneficial effects after extubation. © The Author(s). 2018
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title_short	High-flow nasal cannula in adults with acute respiratory failure and after extubation: a systematic review and meta-analysis
url	https://dx.doi.org/10.1186/s12931-018-0908-7
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author2	Li, Yimin Zhou, Jianmeng Li, Xi Huang, Yongbo Liu, Xiaoqing Burns, Karen E. A. Zhong, Nanshan Zhang, Haibo
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High-flow nasal cannula in adults with acute respiratory failure and after extubation: a systematic review and meta-analysis

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