Use High-Flow Nasal Cannula for Acute Respiratory Failure Patients in the Emergency Department: A Meta-Analysis Study
Objective. To evaluate the efficacy of high-flow nasal cannula (HFNC) therapy compared with conventional oxygen therapy (COT) or noninvasive ventilation (NIV) for the treatment of acute respiratory failure (ARF) in emergency departments (EDs). Method. We comprehensively searched 3 databases (PubMed,...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2019/2130935 |
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| author | Cheng-Chieh Huang Hao-Min Lan Chao-Jui Li Tsung-Han Lee Wen-Liang Chen Wei-Yuan Lei Pei-You Hsieh Mei-Chueh Yang Chu-Chung Chou Han-Ping Wu Yuan-Jhen Syue |
| author_facet | Cheng-Chieh Huang Hao-Min Lan Chao-Jui Li Tsung-Han Lee Wen-Liang Chen Wei-Yuan Lei Pei-You Hsieh Mei-Chueh Yang Chu-Chung Chou Han-Ping Wu Yuan-Jhen Syue |
| author_sort | Cheng-Chieh Huang |
| collection | DOAJ |
| description | Objective. To evaluate the efficacy of high-flow nasal cannula (HFNC) therapy compared with conventional oxygen therapy (COT) or noninvasive ventilation (NIV) for the treatment of acute respiratory failure (ARF) in emergency departments (EDs). Method. We comprehensively searched 3 databases (PubMed, EMBASE, and the Cochrane Library) for articles published from database inception to 12 July 2019. This study included only randomized controlled trials (RCTs) that were conducted in EDs and compared HFNC therapy with COT or NIV. The primary outcome was the intubation rate. The secondary outcomes were the mortality rate, intensive care unit (ICU) admission rate, ED discharge rate, need for escalation, length of ED stay, length of hospital stay, and patient dyspnea and comfort scores. Result. Five RCTs (n = 775) were included. There was a decreasing trend regarding the application of HFNC therapy and the intubation rate, but the difference was not statistically significant (RR, 0.53; 95% CI, 0.26–1.09; p=0.08; I2 = 0%). We found that compared with patients who underwent COT, those who underwent HFNC therapy had a reduced need for escalation (RR, 0.41; 95% CI, 0.22–0.78; p=0.006; I2 = 0%), reduced dyspnea scores (MD −0.82, 95% CI −1.45 to −0.18), and improved comfort (SMD −0.76 SD, 95% CI −1.01 to −0.51). Compared with the COT group, the HFNC therapy group had a similar mortality rate (RR, 1.25; 95% CI, 0.79–1.99; p=0.34; I2 = 0%), ICU admission rate (RR, 1.11; 95% CI, 0.58–2.12; p=0.76; I2 = 0%), ED discharge rate (RR, 1.04; 95% CI, 0.63–1.72; p=0.87; I2 = 0%), length of ED stay (MD 1.66, 95% CI −0.95 to 4.27), and hospital stay (MD 0.9, 95% CI −2.06 to 3.87). Conclusion. Administering HFNC therapy in ARF patients in EDs might decrease the intubation rate compared with COT. In addition, it can decrease the need for escalation, decrease the patient’s dyspnea level, and increase the patient’s comfort level compared with COT. |
| format | Article |
| id | doaj-art-f13d484c651b4a8fb211211f7dc3de4a |
| institution | Kabale University |
| issn | 2090-2840 2090-2859 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-f13d484c651b4a8fb211211f7dc3de4a2025-02-03T05:50:17ZengWileyEmergency Medicine International2090-28402090-28592019-01-01201910.1155/2019/21309352130935Use High-Flow Nasal Cannula for Acute Respiratory Failure Patients in the Emergency Department: A Meta-Analysis StudyCheng-Chieh Huang0Hao-Min Lan1Chao-Jui Li2Tsung-Han Lee3Wen-Liang Chen4Wei-Yuan Lei5Pei-You Hsieh6Mei-Chueh Yang7Chu-Chung Chou8Han-Ping Wu9Yuan-Jhen Syue10Department of Emergency Medicine, Changhua Christian Hospital, Changhua, TaiwanDepartment of Education, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, TaiwanDepartment of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Emergency Medicine, Changhua Christian Hospital, Changhua, TaiwanDepartment of Biological Science and Technology, National Chiao Tung University, Hsinchu, TaiwanDepartment of Emergency Medicine, Changhua Christian Hospital, Changhua, TaiwanDepartment of Emergency Medicine, Changhua Christian Hospital, Changhua, TaiwanDepartment of Emergency Medicine, Changhua Christian Hospital, Changhua, TaiwanDepartment of Emergency Medicine, Changhua Christian Hospital, Changhua, TaiwanDepartment of Pediatric Emergency Medicine, Children Hospital, China Medical University, Taichung, TaiwanDepartment of Anaesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanObjective. To evaluate the efficacy of high-flow nasal cannula (HFNC) therapy compared with conventional oxygen therapy (COT) or noninvasive ventilation (NIV) for the treatment of acute respiratory failure (ARF) in emergency departments (EDs). Method. We comprehensively searched 3 databases (PubMed, EMBASE, and the Cochrane Library) for articles published from database inception to 12 July 2019. This study included only randomized controlled trials (RCTs) that were conducted in EDs and compared HFNC therapy with COT or NIV. The primary outcome was the intubation rate. The secondary outcomes were the mortality rate, intensive care unit (ICU) admission rate, ED discharge rate, need for escalation, length of ED stay, length of hospital stay, and patient dyspnea and comfort scores. Result. Five RCTs (n = 775) were included. There was a decreasing trend regarding the application of HFNC therapy and the intubation rate, but the difference was not statistically significant (RR, 0.53; 95% CI, 0.26–1.09; p=0.08; I2 = 0%). We found that compared with patients who underwent COT, those who underwent HFNC therapy had a reduced need for escalation (RR, 0.41; 95% CI, 0.22–0.78; p=0.006; I2 = 0%), reduced dyspnea scores (MD −0.82, 95% CI −1.45 to −0.18), and improved comfort (SMD −0.76 SD, 95% CI −1.01 to −0.51). Compared with the COT group, the HFNC therapy group had a similar mortality rate (RR, 1.25; 95% CI, 0.79–1.99; p=0.34; I2 = 0%), ICU admission rate (RR, 1.11; 95% CI, 0.58–2.12; p=0.76; I2 = 0%), ED discharge rate (RR, 1.04; 95% CI, 0.63–1.72; p=0.87; I2 = 0%), length of ED stay (MD 1.66, 95% CI −0.95 to 4.27), and hospital stay (MD 0.9, 95% CI −2.06 to 3.87). Conclusion. Administering HFNC therapy in ARF patients in EDs might decrease the intubation rate compared with COT. In addition, it can decrease the need for escalation, decrease the patient’s dyspnea level, and increase the patient’s comfort level compared with COT.http://dx.doi.org/10.1155/2019/2130935 |
| spellingShingle | Cheng-Chieh Huang Hao-Min Lan Chao-Jui Li Tsung-Han Lee Wen-Liang Chen Wei-Yuan Lei Pei-You Hsieh Mei-Chueh Yang Chu-Chung Chou Han-Ping Wu Yuan-Jhen Syue Use High-Flow Nasal Cannula for Acute Respiratory Failure Patients in the Emergency Department: A Meta-Analysis Study Emergency Medicine International |
| title | Use High-Flow Nasal Cannula for Acute Respiratory Failure Patients in the Emergency Department: A Meta-Analysis Study |
| title_full | Use High-Flow Nasal Cannula for Acute Respiratory Failure Patients in the Emergency Department: A Meta-Analysis Study |
| title_fullStr | Use High-Flow Nasal Cannula for Acute Respiratory Failure Patients in the Emergency Department: A Meta-Analysis Study |
| title_full_unstemmed | Use High-Flow Nasal Cannula for Acute Respiratory Failure Patients in the Emergency Department: A Meta-Analysis Study |
| title_short | Use High-Flow Nasal Cannula for Acute Respiratory Failure Patients in the Emergency Department: A Meta-Analysis Study |
| title_sort | use high flow nasal cannula for acute respiratory failure patients in the emergency department a meta analysis study |
| url | http://dx.doi.org/10.1155/2019/2130935 |
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