Comparison between high flow nasal cannula and non-invasive mechanical ventilation in the management of patients with acute respiratory failure: A meta-analysis

Mahdy, Enas Wageih; Abd El-Hamid, Ahmed Mostafa; Ahmed Ibrahim Kotb, Doaa Kamal; Rizk Ibrahim, Emad Fawzy

doi:10.21608/bmfj.2024.267052.2009

Comparison between high flow nasal cannula and non-invasive mechanical ventilation in the management of patients with acute respiratory failure: A meta-analysis

Document Type : Review Article

Authors

¹ Assistant Professor of Anesthesia &amp; Intensive Care Faculty of Medicine - Benha University

² Department of anesthesia &amp; intensive care, Faculty of Medicine, Benha University

³ Department of Critical Care Medicine, Faculty of Medicine, Benha University

10.21608/bmfj.2024.267052.2009

Abstract

Background: Acute respiratory failure is potentially life threatening. It does not require immediate intubation and the likelihood of a positive result hinges on the doctor's capacity to promptly identify the syndrome and implement suitable actions to aid and recover respiratory system function. Objectives: The research aimed to contrast the use of high-flow nasal cannula and non-invasive mechanical ventilation in treating patients experiencing acute respiratory failure. Study design: A meta-analysis study adhering to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines was conducted. Methods: Online databases (PubMed, Embase, Biomed, and the Cochrane Central Register of Controlled trials) were utilized to detect all published randomized studies that compare the impact of high-flow nasal cannula with non-invasive ventilation in patients dealing with acute respiratory failure. Results: Thirteen trials, encompassing a total of 1284 patients, were incorporated in the study. The risk of bias was minimal. The results revealed no substantial decrease in mortality. There was a significant reduction in length of hospital stay and a significant improvement in comfort score favouring the high flow nasal cannula group. However, there was no significant change in length of ICU stay, intubation rate, PaCO2, PaO2, PaO2/FiO2 ratio, SpO2, MAP and HR. Conclusion: This meta-analysis showed no significance of high flow nasal cannula over non-invasive mechanical ventilation in reducing mortality rates. However, high flow nasal cannula is associated with reduction of length of hospital stay and improvement of comfort score.

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