Your browser doesn't support javascript.

Portal Regional da BVS

Informação e Conhecimento para a Saúde

Home > Pesquisa > ()
XML
Imprimir Exportar

Formato de exportação:

Exportar

Email
Adicionar mais destinatários
| |

The Effect of High-Flow Nasal Cannula Oxygen Therapy on Mortality and Intubation Rate in Acute Respiratory Failure: A Systematic Review and Meta-Analysis.

Crit Care Med; 45(4): e449-e456, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27611978

OBJECTIVE:

High-flow nasal cannulae are used in adults with or at risk of acute respiratory failure. We conducted a systematic review and meta-analysis to evaluate the evidence for their use in this setting.DATA SOURCES: Ovid Medline, Embase, and Cochrane Database of Systematic Reviews.STUDY SELECTION: Databases were searched for randomized controlled trials comparing administration of high-flow nasal cannulae with usual care (i.e., conventional oxygen therapy or noninvasive ventilation) in adults with respiratory failure. The primary outcome was hospital mortality; the rate of intubation and assessment of delirium and comfort were secondary outcomes.DATA EXTRACTION: One hundred forty-seven nonduplicate citations were screened, 32 underwent full screening and data extraction, and 14 trials were eligible for inclusion in the review. Nine trials were used in the meta-analysis, including a total of 2,507 subjects.

DATA SYNTHESIS:

When high-flow nasal cannulae were compared with usual care, there was no difference in mortality (high-flow nasal cannulae, 60/1,006 [6%] vs usual care, 90/1,106 [8.1%]) (n = 2,112; p = 0.29; I, 25%; fixed effect model: odds ratio, 0.83; 95% CI, 0.58-1.17) or rate of intubation (high-flow nasal cannulae, 119/1,207 [9.9%] vs usual care, 204/1,300 [15.7%]) (n = 2,507; p = 0.08; I, 53%; random effect model: odds ratio, 0.63; 95% CI, 0.37-1.06). A qualitative analysis of 13 studies on tolerability and comfort suggested that high-flow nasal cannulae are associated with improved patient comfort and dyspnea scores. Trial sequential analyses on primary and secondary outcomes suggested that required information size was not reached.

CONCLUSIONS:

No difference in mortality or intubation was detected in patients with acute respiratory failure treated with high-flow nasal cannulae compared with usual care. High-flow nasal cannulae seem well tolerated by patients. Further large randomized controlled trials are required to evaluate their utility in this setting.