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High-flow nasal cannula for acute exacerbation of chronic obstructive pulmonary disease: A systematic review and

Peng-Lei Yang¹, Jiang-Quan Yu², Han-Bing Chen¹

¹Graduate school of Dalian Medical University, Dalian, Liaoning province, China; Department of Critical Care Medicine, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China.

Heart & Lung : the Journal of Critical Care

|December 28, 2020

Abstract

Background:

The evidence for the safety of high-flow nasal cannula (HFNC) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients is conflicting.

Objectives:

To evaluate the intubation and mortality risks of HFNC compared to non-invasive ventilation (NIV) and conventional oxygen therapy (COT) for AECOPD patients.

Methods:

A search of electronic databases was performed. Studies that used HFNC to treat AECOPD patients were identified.

Results:

Seven RCTs and one observational study were included. There were no differences in intubation risk (risk ratio (RR) 0.94, 95% confidence interval (CI) 0.49 to 1.78, p = 0.84, very low certainty) and mortality risk (RR 0.91, 95% CI 0.46 to 1.79, p = 0.77, very low certainty) for HFNC compared with NIV. No data were available for intubation or mortality risk for HFNC compared with COT.

Conclusion:

For AECOPD patients, low-quality evidence indicates that HFNC does not increase intubation and mortality risks compared to NIV.

Keywords:

Chronic obstructive pulmonary disease Meta-analysis Non-invasive ventilation Oxygen therapy

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