Efficacy of High-Flow Nasal Cannula Therapy in Intensive Care Units

Timothy N Liesching, Yuxiu Lei
Journal of Intensive Care Medicine 2017 January 1, : 885066616689043

PURPOSE: We conducted a meta-analysis to compare the physiological and clinical outcomes of high-flow nasal cannula (HFNC) with standard oxygen (O2 ) or conventional noninvasive ventilation (NIV) in intensive care units (ICUs).

PROCEDURES: We selected the full-text prospective studies comparing HFNC with standard O2 or NIV in ICU. The continuous variables were analyzed with sample size-adjusted pooled t test. The categorical variables were extracted and combined for recalculating odds ratio.

FINDINGS: We included 18 articles with 2004 patients. No difference was observed in the below outcomes comparing HFNC with standard O2 : oxygen saturation (95.0% vs 93.8%, P = .27), Pao2 /Fio2 (217.7 vs 161.9 mm Hg, P = .29), Paco2 (38.3 vs 39.3 mm Hg, P = .33), pH (7.416 vs 7.419, P = .90), discomfort (1.19 vs 1.44, P = .44), intubation or reintubation rate (odds ratio = 0.79, 95% confidence interval [CI]: 0.39-1.21, P = .27), and ICU stay (4.0 vs 4.5 days, P = .90). Below outcomes were modestly improved with HFNC compared to standard O2 : respiratory rate (21.6 vs 24.7, P = .06) and ICU mortality (odds ratio = 0.69, 95% CI: 0.43-1.11, P = .13). Below outcomes were significantly improved with HFNC compared to standard O2 : heart rate (89.1 vs 98.4, P = .03), Pao2 (104.5 vs 90.0 mm Hg, P = .04), and dyspnea (2.7 vs 4.3, P = .05). When comparing HFNC to NIV, below outcomes were significantly lower: Pao2 (106.9 vs 134.2 mm Hg, P = .02), Pao2 /Fio2 (178.4 vs 220.0 mm Hg, P = .02), Paco2 (37.7 vs 39.2 mm Hg, P = .04), and ICU mortality (odds ratio = 0.39, 95% CI: 0.19-0.82, P = .01).

CONCLUSION: When comparing to standard O2 , the most effective outcomes from HFNC are reduced heart rate and dyspnea in both ICU and critical care unit patients. The HFNC modestly reduced intubation rate and ICU mortality. Patients with pneumonia may benefit from HFNC in reduced respiratory rate, heart rate, dyspnea, discomfort, intubation rate, ICU mortality, ICU stay, and improved Pao2 . When comparing to NIV, HFNC group did not do as good in Pao2 and Pao2 /Fio2 but had a slightly lower intubation rate and ICU mortality.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.


Sort by: Most RecentHighest Rated

Darell Heiselman

In the conclusion "did not do as WELL" ; not good


Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"