High-Flow Nasal Cannula in Critically Ill Subjects With or at Risk for Respiratory Failure: A Systematic Review and Meta-Analysis.

High-flow nasal cannula (HFNC) oxygen delivery has been gaining attention as an alternative means of respiratory support for critically ill patients, with recent studies suggesting equivalent outcomes when compared with other forms of oxygen therapy delivery. The main objective of this review was to...

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Publicado en:Respiratory Care Vol. 62; no. 1; pp. 123 - 133
Autores principales: Nedel, Wagner Luis, Deutschendorf, Caroline, Rodrigues Filho, Edison Moraes
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Jan2017
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Mary Ann Liebert, Inc.
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        atl: High-Flow Nasal Cannula in Critically Ill Subjects With or at Risk for Respiratory Failure: A Systematic Review and Meta-Analysis.
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        au:
          Nedel, Wagner Luis
          Deutschendorf, Caroline
          Rodrigues Filho, Edison Moraes
        affil: ICU, Hospital Nossa Senhora da Conceição and the ICU, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
      sug:
        subj:
          Nasal Cannula
          Critically Ill Patients
          Respiratory Failure Risk Factors
          Oxygen Therapy Methods
          Human
          Systematic Review
          Meta Analysis
          Descriptive Statistics
          Confidence Intervals
          Odds Ratio
          Respiratory Failure Prevention and Control
          Noninvasive Procedures
          Respiration, Artificial
          Oxygenation
          Carbon Dioxide
          Comparative Studies
          Mortality
          Medline
          Cochrane Library
          Embase
          Data Analysis Software
          Mantel-Haenszel Test
          Chi Square Test
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          Female
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          Middle Age
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          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
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          Female
      ab: High-flow nasal cannula (HFNC) oxygen delivery has been gaining attention as an alternative means of respiratory support for critically ill patients, with recent studies suggesting equivalent outcomes when compared with other forms of oxygen therapy delivery. The main objective of this review was to extract current data about the efficacy of HFNC in critically ill subjects with or at risk for respiratory failure. We performed a systematic review of publications (from database inception to October 2015) that evaluated HFNC in critically ill subjects with or at risk for acute respiratory failure and performed a meta-analysis comparing HFNC with noninvasive ventilation (NIV) and with standard oxygen therapy regarding major outcomes: incidence of invasive mechanical ventilation and ICU mortality. A total of 9 studies were included. HFNC was not associated with a reduction in the incidence of invasive mechanical ventilation compared with NIV (odds ratio [OR] 0.83,95% Cl 0.57-1.20, P = .31) or standard oxygen therapy (OR 0.49, 95% Cl 0.22-1.08, P = .17). Additionally, HFNC use did not reduce ICU mortality compared with NIV (OR 0.72, 95% Cl 0.23-2.21, P = .56) or with standard oxygen therapy (OR 0.69, 95% Cl 0.33-1.42, P = .29). There was a trend toward better oxygenation compared with conventional oxygen therapy but a worse gas exchange compared with NIV. At this moment, HFNC therapy seems not to be superior to conventional oxygen therapy or NIV in terms of invasive mechanical ventilation rate or ICU mortality in critical illness, but new studies are needed to determine whether HFNC is associated with any difference in major outcomes when compared with other techniques.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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