OVERVIEW DE REVISÕES SISTEMÁTICAS: COMPARAÇÃO ENTRE A CÂNULA NASAL DE ALTO FLUXO E A OXIGENOTERAPIA CONVENCIONAL
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Resumo
Foi realizada uma revisão geral das revisões sistemáticas (RSs) sobre os efeitos da cânula nasal de alto fluxo (CNAF) em comparação com a oxigenoterapia convencional (OC) em adultos e o nível de confiabilidade dos estudos. O objetivo do estudo foi comparar a CNAF em relação à OC na Insuficiência respiratória aguda (IRpA). Metodologicamente, as buscas foram realizadas em três bases de dados e literatura cinzenta entre fevereiro e março de 2023. Doze RSs foram selecionadas. Os desfechos avaliados foram mortalidade, risco de intubação, tempo de internação, necessidade de maior suporte respiratório/falha do tratamento, PaO2/FiO2 e nível de CO2. A ferramenta para avaliar a qualidade metodológica das RSs incluídas foi a AMSTAR 2. Os resultados deste estudo apontam que Das 12 RSs incluídas, 5 eram RSs com meta-análise de rede e 7 RSs com meta-análise convencional. A avaliação de confiança das RSs foi estratificada como moderada em uma, baixa em oito e criticamente baixa em três. A conclusão da pesquisa é de que a CNAF pode reduzir o risco de intubação e a escalada do suporte respiratório em pacientes adultos com IRpA. A confiança geral dos estudos foi muito baixa. Os dados são inconclusivos quanto ao impacto da CNAF na oxigenação e nos níveis de CO2. Não houve efeito da CNAF sobre a mortalidade e o tempo de internação na unidade de terapia intensiva e no hospital. Este overview poderá ser útil nas decisões clínicas, melhoria da qualidade assistencial, e na avaliação de incorporação de tecnologias em saúde.
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