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Abstract
BACKGROUND: High-flow nasal cannula (HFNC) oxygen therapy is widely used in extubated patients. We aim to evaluate the effect of HFNC compared with conventional oxygen therapy in adults after cardiothoracic surgery.
METHODS: We conducted a literature search in PubMed, Embase, and ClinicalTrials for randomized controlled trials that compared HFNC with conventional oxygen therapy in extubated patients after cardiothoracic surgery.
RESULTS: Eight studies with 1,086 subjects were included. Compared with conventional oxygen therapy, HFNC was associated with a significant reduction in the need for escalation of respiratory support (risk ratio 0.40, 95% CI 0.26–0.61, P < .001), re-intubation rate (risk ratio 0.35, 95% CI 0.13–0.96, P = .04), and length of hospital stay (mean difference –0.48, 95% CI –0.95 to –0.01, P = .05). No significant differences were found for the length of ICU stay (mean difference –0.09, 95% CI –0.21 to –0.04, P = .18), pulmonary complications (risk ratio 0.85, 95% CI 0.48–1.48, P = .56), or mortality rate (risk ratio 0.54, 95% CI 0.12–2.53, P = .44).
CONCLUSIONS: HFNC may significantly reduce the need for the escalation of respiratory support and re-intubation rate, and might reduce the hospital stay. More high-quality randomized controlled trials are needed to further validate our results.
Footnotes
- Correspondence: Zongan Liang MD, Department of Respiratory and Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China. E-mail: liangzongan817{at}163.com
This work was supported in part by the National Key Research and Development Program of China (2016YFC1304303). The authors have disclosed no conflicts of interest.
Supplementary material related to this paper is available at http://www.rcjournal.com.
- Copyright © 2020 by Daedalus Enterprises
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