Comparison between high-flow nasal cannula and noninvasive ventilation in COVID-19 patients: a systematic review and meta-analysis.
Ther Adv Respir Dis
; 16: 17534666221113663, 2022.
Статья
в английский
| MEDLINE | ID: covidwho-1950910
ABSTRACT
BACKGROUND:
High-flow nasal cannula (HFNC) and noninvasive ventilation (NIV) are important treatment approaches for acute hypoxemic respiratory failure (AHRF) in coronavirus disease 2019 (COVID-19) patients. However, the differential impact of HFNC versus NIV on clinical outcomes of COVID-19 is uncertain.OBJECTIVES:
We assessed the effects of HFNC versus NIV (interface or mode) on clinical outcomes of COVID-19.METHODS:
We searched PubMed, EMBASE, Web of Science, Scopus, MedRxiv, and BioRxiv for randomized controlled trials (RCTs) and observational studies (with a control group) of HFNC and NIV in patients with COVID-19-related AHRF published in English before February 2022. The primary outcome of interest was the mortality rate, and the secondary outcomes were intubation rate, PaO2/FiO2, intensive care unit (ICU) length of stay (LOS), hospital LOS, and days free from invasive mechanical ventilation [ventilator-free day (VFD)].RESULTS:
In all, 23 studies fulfilled the selection criteria, and 5354 patients were included. The mortality rate was higher in the NIV group than the HFNC group [odds ratio (OR) = 0.66, 95% confidence interval (CI) 0.51-0.84, p = 0.0008, I2 = 60%]; however, in this subgroup, no significant difference in mortality was observed in the NIV-helmet group (OR = 1.21, 95% CI 0.63-2.32, p = 0.57, I2 = 0%) or NIV-continuous positive airway pressure (CPAP) group (OR = 0.77, 95% CI 0.51-1.17, p = 0.23, I2 = 65%) relative to the HFNC group. There were no differences in intubation rate, PaO2/FiO2, ICU LOS, hospital LOS, or days free from invasive mechanical ventilation (VFD) between the HFNC and NIV groups.CONCLUSION:
Although mortality was lower with HFNC than NIV, there was no difference in mortality between HFNC and NIV on a subgroup of helmet or CPAP group. Future large sample RCTs are necessary to prove our findings. REGISTRATION This systematic review and meta-analysis protocol was prospectively registered with PROSPERO (no. CRD42022321997).ключевые слова
Полный текст:
Имеется в наличии
Коллекция:
Международные базы данных
база данных:
MEDLINE
Основная тема:
Respiratory Insufficiency
/
Noninvasive Ventilation
/
COVID-19
Тип исследования:
Экспериментальные исследования
/
Наблюдательное исследование
/
Прогностическое исследование
/
Рандомизированные контролируемые испытания
/
Отзывы
/
Систематический обзор/метаанализ
Пределы темы:
Люди
Язык:
английский
Журнал:
Ther Adv Respir Dis
Тематика журнала:
Болезни органов дыхания - специальность-
/
Терапия
Год:
2022
Тип:
Статья
Аффилированная страна:
17534666221113663
Документы, близкие по теме
MEDLINE
...
LILACS
LIS