{"title":"High-flow nasal cannula therapy versus conventional oxygen therapy for adult patients after cardiac surgery: A systemic review and meta-analysis","authors":"Chuantao Liu, Qihong Lin, Dongyu Li","doi":"10.1016/j.hrtlng.2024.03.008","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Oxygen therapy constitutes a crucial element of post-cardiac operative care. The study assessed the effectiveness of high-flow nasal cannula (HFNC) in comparison to conventional oxygen therapy (COT).</p></div><div><h3>Objectives</h3><p>The aim of the study was to assess the effectiveness of HFNC in comparison to COT for adult patients following cardiac surgery.</p></div><div><h3>Methods</h3><p>We conducted a comprehensive search of Embase, PubMed, Scopus, Cochrane Library, and Web of Science databases from inception until April 18, 2023, to identify randomized controlled trials (RCTs) and crossover studies that compared the efficacy of HFNC with COT in adult patients following cardiac surgery.</p></div><div><h3>Results</h3><p>The meta-analysis included nine studies, consisting of eight RCTs and one crossover study. Compared with COT, HFNC could reduce the need for escalation of respiratory support (RR 0.67, 95% CI: 0.48 to 0.93, <em>P</em> = 0.02), decrease arterial partial pressure of carbon dioxide (PaCO<sub>2</sub>) levels (MD -3.14, 95% CI: -4.90 to -1.39, <em>P</em><0.001), and increase forced expiratory volume in 1 second (FEV<sub>1</sub>) levels (MD 0.08, 95% CI: 0.02 to 0.15, <em>P</em> = 0.02). There was no significant difference between the HFNC and COT groups in terms of mortality, intubation rate, respiratory rate, heart rate, intensive care unit and hospital length of stay, arterial partial pressure of oxygen (PaO<sub>2</sub>), forced vital capacity, and complications of atrial fibrillation and delirium.</p></div><div><h3>Conclusion</h3><p>Compared with COT, HFNC could decrease the need for escalation of respiratory support, lower PaCO<sub>2</sub> levels, and elevate FEV<sub>1</sub> levels in patients following cardiac surgery.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.4000,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324000475/pdfft?md5=862ff95c5c48ace6aedf9c998057a17d&pid=1-s2.0-S0147956324000475-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart & Lung","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0147956324000475","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Oxygen therapy constitutes a crucial element of post-cardiac operative care. The study assessed the effectiveness of high-flow nasal cannula (HFNC) in comparison to conventional oxygen therapy (COT).
Objectives
The aim of the study was to assess the effectiveness of HFNC in comparison to COT for adult patients following cardiac surgery.
Methods
We conducted a comprehensive search of Embase, PubMed, Scopus, Cochrane Library, and Web of Science databases from inception until April 18, 2023, to identify randomized controlled trials (RCTs) and crossover studies that compared the efficacy of HFNC with COT in adult patients following cardiac surgery.
Results
The meta-analysis included nine studies, consisting of eight RCTs and one crossover study. Compared with COT, HFNC could reduce the need for escalation of respiratory support (RR 0.67, 95% CI: 0.48 to 0.93, P = 0.02), decrease arterial partial pressure of carbon dioxide (PaCO2) levels (MD -3.14, 95% CI: -4.90 to -1.39, P<0.001), and increase forced expiratory volume in 1 second (FEV1) levels (MD 0.08, 95% CI: 0.02 to 0.15, P = 0.02). There was no significant difference between the HFNC and COT groups in terms of mortality, intubation rate, respiratory rate, heart rate, intensive care unit and hospital length of stay, arterial partial pressure of oxygen (PaO2), forced vital capacity, and complications of atrial fibrillation and delirium.
Conclusion
Compared with COT, HFNC could decrease the need for escalation of respiratory support, lower PaCO2 levels, and elevate FEV1 levels in patients following cardiac surgery.
期刊介绍:
Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders.
The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.