SYSTEMATIC REVIEWS OVERVIEW: COMPARISON BETWEEN HIGH-FLOW NASAL CANNULA AND CONVENTIONAL OXYGEN THERAPY
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Abstract
A general review of systematic reviews (SRs) was conducted on the effects of high-flow nasal cannula (HFNC) compared to conventional oxygen therapy (COT) in adults, as well as the level of study reliability. The objective of the study was to compare HFNC with COT in acute respiratory failure (ARF). Methodologically, searches were conducted in three databases and gray literature between February and March 2023. Twelve SRs were selected. The outcomes evaluated were mortality, risk of intubation, length of hospital stay, need for higher respiratory support/treatment failure, PaO2/FiO2 ratio, and CO2 levels. The tool used to assess the methodological quality of the included SRs was AMSTAR 2. The results of this study point out that from the 12 SRs included, 5 were SRs with network meta-analysis and 7 SRs with conventional meta-analysis. The confidence evaluation of the SRs was stratified as moderate in one, low in eight, and critically low in three. The conclusion of the research os that HFNC may reduce the risk of intubation and the escalation of respiratory support in adult patients with ARF. The overall confidence in the studies was very low. The data are inconclusive regarding the impact of HFNC on oxygenation and CO2 levels. No effect of HFNC was observed on mortality or the length of stay in the intensive care unit and hospital. This overview may be useful for clinical decision-making, improving the quality of care, and assessing the incorporation of health technologies.
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This work is licensed under a Creative Commons Attribution 4.0 International License.
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