Abstract
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. 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. 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). 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.
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