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High flow nasal cannula versus conventional oxygen therapy and non-invasive ventilation in adults with acute hypoxemic respiratory failure: A systematic review.
Respir Med. 2016 12; 121:100-108.RM

Abstract

INTRODUCTION

Humidified oxygen via a high flow nasal cannula (HFNC) is a form of supplemental oxygen therapy that has significant theoretical advantages over conventional oxygen therapy (COT). However, the clinical role of HFNC in acute hypoxemic respiratory failure (AHRF) has not been well established. This review compares the efficacy of HFNC with COT and non-invasive ventilation (NIV) in patients with AHRF.

METHODS

Studies reviewed were selected based on relevance from a systematic literature search conducted in Medline and EMBASE to include all published original research through May 2016. Twelve studies matched the inclusion criteria.

RESULTS

In the majority of the studies, HFNC was associated with superior comfort and patient tolerance as compared to NIV or COT. HFNC was associated with reduced work of breathing in comparison with COT in some, but not all, studies in the review. COT and NIV were associated with a higher 90-day mortality rate compared to HFNC in only one multicenter randomized trial versus no mortality difference reported by others. Three out of four studies demonstrated a decreased need for escalation of oxygen therapy with HFNC. Six out of eight studies demonstrated improved oxygenation with HFNC as compared to COT. Two of three studies revealed worse oxygenation with HFNC as compared to NIV.

CONCLUSION

This review suggests that HFNC may be superior to COT in AHRF patients in terms of oxygenation, patient comfort, and work of breathing. It may be reasonable to consider HFNC as an intermediate level of oxygen therapy between COT and NIV.

Authors+Show Affiliations

Aventura Hospital and Medical Center, 20900 Biscayne Blvd, Aventura, FL 33180, United States. Electronic address: u9301412@cmu.edu.tw.Aventura Hospital and Medical Center, 20900 Biscayne Blvd, Aventura, FL 33180, United States. Electronic address: dmnkodi@gmail.com.Aventura Hospital and Medical Center, 20900 Biscayne Blvd, Aventura, FL 33180, United States. Electronic address: sshaharyar@gmail.com.Aventura Hospital and Medical Center, 20900 Biscayne Blvd, Aventura, FL 33180, United States. Electronic address: sharmilar85@gmail.com.Aventura Hospital and Medical Center, 20900 Biscayne Blvd, Aventura, FL 33180, United States. Electronic address: mauriciodanckers@outlook.com.Aventura Hospital and Medical Center, 20900 Biscayne Blvd, Aventura, FL 33180, United States. Electronic address: phersco@gmail.com.Aventura Hospital and Medical Center, 20900 Biscayne Blvd, Aventura, FL 33180, United States. Electronic address: molly.moor@hcahealthcare.com.Aventura Hospital and Medical Center, 20900 Biscayne Blvd, Aventura, FL 33180, United States. Electronic address: gferrer@icehealthnet.com.

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

27888983

Citation

Lee, Chi Chan, et al. "High Flow Nasal Cannula Versus Conventional Oxygen Therapy and Non-invasive Ventilation in Adults With Acute Hypoxemic Respiratory Failure: a Systematic Review." Respiratory Medicine, vol. 121, 2016, pp. 100-108.
Lee CC, Mankodi D, Shaharyar S, et al. High flow nasal cannula versus conventional oxygen therapy and non-invasive ventilation in adults with acute hypoxemic respiratory failure: A systematic review. Respir Med. 2016;121:100-108.
Lee, C. C., Mankodi, D., Shaharyar, S., Ravindranathan, S., Danckers, M., Herscovici, P., Moor, M., & Ferrer, G. (2016). High flow nasal cannula versus conventional oxygen therapy and non-invasive ventilation in adults with acute hypoxemic respiratory failure: A systematic review. Respiratory Medicine, 121, 100-108. https://doi.org/10.1016/j.rmed.2016.11.004
Lee CC, et al. High Flow Nasal Cannula Versus Conventional Oxygen Therapy and Non-invasive Ventilation in Adults With Acute Hypoxemic Respiratory Failure: a Systematic Review. Respir Med. 2016;121:100-108. PubMed PMID: 27888983.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High flow nasal cannula versus conventional oxygen therapy and non-invasive ventilation in adults with acute hypoxemic respiratory failure: A systematic review. AU - Lee,Chi Chan, AU - Mankodi,Dhruti, AU - Shaharyar,Sameer, AU - Ravindranathan,Sharmila, AU - Danckers,Mauricio, AU - Herscovici,Pablo, AU - Moor,Molly, AU - Ferrer,Gustavo, Y1 - 2016/11/03/ PY - 2016/06/21/received PY - 2016/09/15/revised PY - 2016/11/02/accepted PY - 2016/11/28/entrez PY - 2016/11/28/pubmed PY - 2018/1/9/medline KW - High flow nasal cannula KW - High flow oxygen KW - Non-invasive ventilation KW - Oxygen therapy KW - Respiratory failure SP - 100 EP - 108 JF - Respiratory medicine JO - Respir Med VL - 121 N2 - INTRODUCTION: Humidified oxygen via a high flow nasal cannula (HFNC) is a form of supplemental oxygen therapy that has significant theoretical advantages over conventional oxygen therapy (COT). However, the clinical role of HFNC in acute hypoxemic respiratory failure (AHRF) has not been well established. This review compares the efficacy of HFNC with COT and non-invasive ventilation (NIV) in patients with AHRF. METHODS: Studies reviewed were selected based on relevance from a systematic literature search conducted in Medline and EMBASE to include all published original research through May 2016. Twelve studies matched the inclusion criteria. RESULTS: In the majority of the studies, HFNC was associated with superior comfort and patient tolerance as compared to NIV or COT. HFNC was associated with reduced work of breathing in comparison with COT in some, but not all, studies in the review. COT and NIV were associated with a higher 90-day mortality rate compared to HFNC in only one multicenter randomized trial versus no mortality difference reported by others. Three out of four studies demonstrated a decreased need for escalation of oxygen therapy with HFNC. Six out of eight studies demonstrated improved oxygenation with HFNC as compared to COT. Two of three studies revealed worse oxygenation with HFNC as compared to NIV. CONCLUSION: This review suggests that HFNC may be superior to COT in AHRF patients in terms of oxygenation, patient comfort, and work of breathing. It may be reasonable to consider HFNC as an intermediate level of oxygen therapy between COT and NIV. SN - 1532-3064 UR - https://www.unboundmedicine.com/medline/citation/27888983/High_flow_nasal_cannula_versus_conventional_oxygen_therapy_and_non_invasive_ventilation_in_adults_with_acute_hypoxemic_respiratory_failure:_A_systematic_review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0954-6111(16)30292-X DB - PRIME DP - Unbound Medicine ER -