High flow nasal cannula versus noninvasive ventilation in the treatment of acute hypercapnic respiratory failure: A systematic review and meta ‐analysis

We conducted a systematic review and meta-analysis to determine if high-flow nasal cannula can be utilised when managing patients with acute hypercapnic respiratory failure, as opposed to noninvasive ventilation which is conventionally used in this regard. We found no statistically significant differences between the two modalities in the correction of arterial blood gases, intubation rates, mortality rates, and treatment switch. AbstractChronic obstructive pulmonary disease can lead to acute hypercapnic respiratory failure (AHRF), often treated using noninvasive ventilation (NIV). Emerging research suggests the potential utility of high flow nasal cannula (HFNC) for AHRF. This systematic review and meta-analysis aimed to determine the effect of HFNC versus NIV on AHRF management. A search of electronic databases (CINAHL, MEDLINE, and Academic Search Complete), web sources, and trial registries was last conducted on 9 February 2023. Quality and risk of bias assessments were conducted. Meta-analyses were used to synthesise data. Seven randomised controlled trials were included. No statistically significant differences between HFNC and NIV were found within the following outcomes of interest: (i) correction of pCO2: standardised mean difference (SMD)  = −0.16, 95% confidence interval (CI) (−0.34 to 0.02),p = 0.08; (ii) correction of pH: SMD = −0.05, 95% CI (−0.25 to 0.14),p = 0.59; (iii) correction of pO2: SMD = −0.15, 95% CI (−0.40 to 0.09),p ...
Source: The Clinical Respiratory Journal - Category: Respiratory Medicine Authors: Tags: REVIEW ARTICLE Source Type: research