Effects Of High-flow Nasal Cannulae On Patients After Extubation:a Meta-analysis

Objective: To evaluate the Effects of high-flow nasal cannulae(HFNC)on patients after extubation by using meta-analysis.Methods: An extensive search of related literature from the EMBASE,Cochrane library,Pub Med,Wanfang databases,Weipu databases and CNKI from January 1980 to December 2017 was performed.Randomized controlled trials(RCTs)regarding comparison of the effect of high-flow nasal cannulae on patients with tracheal intubation after extubation were collected.Meta-analysis was performed by Rev Man 5.3.Results: Finally,l1 studies with 10 English documents,1 Chinese literature,with a total of 3183 patients were included.Comparing with conventional oxygen therapy(COT),HFNC significantly reduce patient reintubation rate and increase oxygenation index(OR 0.49,95%CI:0.25?0.98,Z = 2.01,P = 0.04;MD 55.12,95%CI:35.58?74.67,Z =5.53,P <0.00001),and improve patient comfort.Comparing with non-invasive positive pressure ventilation(NPPV),HFNC cannot reduce patient reintubation rate and increase oxygenation index.Comparing with COT and NPPV separately,HFNC cannot reduce ICU mortality and ICU stay in patients.Conclusion: Compared with COT,HFNC can significantly improve patients’ oxygenation,reduce reintubation rate,and improve patient comfort,but it cannot reduce ICU mortality and ICU length of stay in patients.HFNC has similar efficiency as NPPV.