Eduardo Moya-Gallardo, Jeniffer Fajardo-Gutiérrez, Karol Acevedo, Francisca Verdugo-Paiva, Rocío Bravo-Jeria, Luis Ortiz-Muñoz, Felipe Contreras-Briceño, Maximiliano Espinosa-Ramírez
{"title":"高流量鼻插管在成人慢性呼吸系统疾病患者体育锻炼期间的应用：系统综述和荟萃分析。","authors":"Eduardo Moya-Gallardo, Jeniffer Fajardo-Gutiérrez, Karol Acevedo, Francisca Verdugo-Paiva, Rocío Bravo-Jeria, Luis Ortiz-Muñoz, Felipe Contreras-Briceño, Maximiliano Espinosa-Ramírez","doi":"10.1136/bmjresp-2024-002431","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Chronic respiratory diseases (CRDs) affect at least 545 million people globally, leading to symptoms such as dyspnoea, fatigue and limited physical activity. Pulmonary rehabilitation (PR) programmes aim to improve the exercise capacity and quality of life of patients with CRD through exercise training. High-flow nasal cannula (HFNC) therapy shows potential as an adjunct treatment during exercise, but its effects on CRD populations are unclear. The purpose of this systematic review was to evaluate the effects of HFNC during exercise in people with CRD.</p><p><strong>Methods: </strong>A systematic review was conducted and eight databases and other resources were searched from inception (28 June 2022) to 4 April 2023. Studies that used adult patients with CRD and randomised controlled trial that compared the effect of HFNC versus standard care (conventional oxygen therapy or room air) during exercise were included. Two authors independently selected trials, extracted the data, assessed risks of bias and employed the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach to judging the certainty of evidence. We pooled trials using random-effect models and inverse variance estimation.</p><p><strong>Results: </strong>Seventeen studies (n=8406) were included in the review (570 patients). The evidence suggests that HFNC increases exercise time after multiple training sessions (weighted mean difference (WMD)=160.58 s; 95% 95% CI=67.32-253.83, 2 studies) and increase after a single session (WMD=72.10 s; 95% CI=28.95-115.24, 11 studies). HFNC may result in little improvements in secondary outcomes (quality of life, dyspnoea, comfort, complications and adherence).</p><p><strong>Discussion: </strong>The evidence suggests that HFNC may increase functional exercise capacity and positively enhance secondary outcomes. Continued research is justified to elucidate the role of HFNC in PR during exercise training.</p><p><strong>Prospero registration number: </strong>CRD42022336263.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499805/pdf/","citationCount":"0","resultStr":"{\"title\":\"High-flow nasal cannula in adults with chronic respiratory diseases during physical exercise: a systematic review and meta-analysis.\",\"authors\":\"Eduardo Moya-Gallardo, Jeniffer Fajardo-Gutiérrez, Karol Acevedo, Francisca Verdugo-Paiva, Rocío Bravo-Jeria, Luis Ortiz-Muñoz, Felipe Contreras-Briceño, Maximiliano Espinosa-Ramírez\",\"doi\":\"10.1136/bmjresp-2024-002431\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Chronic respiratory diseases (CRDs) affect at least 545 million people globally, leading to symptoms such as dyspnoea, fatigue and limited physical activity. Pulmonary rehabilitation (PR) programmes aim to improve the exercise capacity and quality of life of patients with CRD through exercise training. High-flow nasal cannula (HFNC) therapy shows potential as an adjunct treatment during exercise, but its effects on CRD populations are unclear. The purpose of this systematic review was to evaluate the effects of HFNC during exercise in people with CRD.</p><p><strong>Methods: </strong>A systematic review was conducted and eight databases and other resources were searched from inception (28 June 2022) to 4 April 2023. Studies that used adult patients with CRD and randomised controlled trial that compared the effect of HFNC versus standard care (conventional oxygen therapy or room air) during exercise were included. Two authors independently selected trials, extracted the data, assessed risks of bias and employed the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach to judging the certainty of evidence. We pooled trials using random-effect models and inverse variance estimation.</p><p><strong>Results: </strong>Seventeen studies (n=8406) were included in the review (570 patients). The evidence suggests that HFNC increases exercise time after multiple training sessions (weighted mean difference (WMD)=160.58 s; 95% 95% CI=67.32-253.83, 2 studies) and increase after a single session (WMD=72.10 s; 95% CI=28.95-115.24, 11 studies). HFNC may result in little improvements in secondary outcomes (quality of life, dyspnoea, comfort, complications and adherence).</p><p><strong>Discussion: </strong>The evidence suggests that HFNC may increase functional exercise capacity and positively enhance secondary outcomes. Continued research is justified to elucidate the role of HFNC in PR during exercise training.</p><p><strong>Prospero registration number: </strong>CRD42022336263.</p>\",\"PeriodicalId\":9048,\"journal\":{\"name\":\"BMJ Open Respiratory Research\",\"volume\":\"11 1\",\"pages\":\"\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2024-10-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499805/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Open Respiratory Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/bmjresp-2024-002431\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Open Respiratory Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjresp-2024-002431","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
High-flow nasal cannula in adults with chronic respiratory diseases during physical exercise: a systematic review and meta-analysis.
Background: Chronic respiratory diseases (CRDs) affect at least 545 million people globally, leading to symptoms such as dyspnoea, fatigue and limited physical activity. Pulmonary rehabilitation (PR) programmes aim to improve the exercise capacity and quality of life of patients with CRD through exercise training. High-flow nasal cannula (HFNC) therapy shows potential as an adjunct treatment during exercise, but its effects on CRD populations are unclear. The purpose of this systematic review was to evaluate the effects of HFNC during exercise in people with CRD.
Methods: A systematic review was conducted and eight databases and other resources were searched from inception (28 June 2022) to 4 April 2023. Studies that used adult patients with CRD and randomised controlled trial that compared the effect of HFNC versus standard care (conventional oxygen therapy or room air) during exercise were included. Two authors independently selected trials, extracted the data, assessed risks of bias and employed the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach to judging the certainty of evidence. We pooled trials using random-effect models and inverse variance estimation.
Results: Seventeen studies (n=8406) were included in the review (570 patients). The evidence suggests that HFNC increases exercise time after multiple training sessions (weighted mean difference (WMD)=160.58 s; 95% 95% CI=67.32-253.83, 2 studies) and increase after a single session (WMD=72.10 s; 95% CI=28.95-115.24, 11 studies). HFNC may result in little improvements in secondary outcomes (quality of life, dyspnoea, comfort, complications and adherence).
Discussion: The evidence suggests that HFNC may increase functional exercise capacity and positively enhance secondary outcomes. Continued research is justified to elucidate the role of HFNC in PR during exercise training.
期刊介绍：
BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.
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