Clinical effects of high flow nasal cannula oxygen therapy in post-extubation intensive care unit patients:a systematic review

Abstract

Objective To evaluate the clinical effects of heated humidified high flow nasal cannula oxygen therapy on post-extubation intensive care unit (ICU) patients. Methods A computerized search was performed through Cochrane Library, EMBASE, PubMed, Elsevier, CNKI, Wanfang Database, SinoMed for randomized controlled trial(RCTs) which studied the effects of clinical effects of heated humidified high flow nasal cannula oxygen therapy on post-extubation ICU patients. Two reviewers separately searched the articles, evaluated the quality of the literatures, extracted date according to the inclusion and exclusion criteria. RevMan5.3 was used for Meta-analysis. Results Five RCTs were included involving 982 patients in the study. The results of meta-analysis showed that the HFNC group was lower than COT group on the re-intubation rate (OR=0.39, 95%CI 0.25-0.62, P 0.05) on post-extubation respiratory failure (OR=0.85, 95%CI 0.35-2.09), respiratory infection (OR=0.69, 95%CI 0.36-1.34), hospital length of stay (MD=0.51, 95%CI-0.02-1.03), mortality of hospital (OR=0.81, 95%CI 0.39-1.69). Conclusions The use of HFNC oxygen therapy can reduce there-intubation rate, improve oxygenation index, comfort level and tolerance on post-extubation ICU patients, while HFNC group has no significant impact on the post-extubation respiratory failure, respiratory infection, hospital length of stay, mortality of hospital compared with COTgroup. However, in view of the quantity and quality of study. More RCTs should be conducted to verify the results. Key words: Complication; Meta-analysis; Heated humidified high flow nasal cannula oxygen therapy; Post-extubation