Volume 19 Issue 6
Jun.  2021
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LIU Qin, XIE Xiang-mei, LUO Jia-jia, JIAO Fan, HU Xiao-ying. The efficacy of high-flow nasal cannula oxygen therapy for patients after extubation: an overview of systematic reviews[J]. Chinese Journal of General Practice, 2021, 19(6): 1029-1034. doi: 10.16766/j.cnki.issn.1674-4152.001977
Citation: LIU Qin, XIE Xiang-mei, LUO Jia-jia, JIAO Fan, HU Xiao-ying. The efficacy of high-flow nasal cannula oxygen therapy for patients after extubation: an overview of systematic reviews[J]. Chinese Journal of General Practice, 2021, 19(6): 1029-1034. doi: 10.16766/j.cnki.issn.1674-4152.001977

The efficacy of high-flow nasal cannula oxygen therapy for patients after extubation: an overview of systematic reviews

doi: 10.16766/j.cnki.issn.1674-4152.001977
Funds:

 20171BBG70019

 20192BBG70013

  • Received Date: 2020-03-27
    Available Online: 2022-02-16
  •   Objective  The aim of this paper was to evaluate the methodological quality and of evidence level for the best evidence, to compare the efficacy and safety of high-flow oxygen therapy with other therapy methods in patients after extubation, and provide reference for the future research priorities of high-flow oxygen therapy in critically ill patients through retrieving systematic review or meta-analysis of patients who were treated with high-flow nasal cannula oxygen therapy after extubation.  Methods  The Cochrane Library, PubMed, Medline, CNKI, CBM, WANFANG and VIP databases were electronically searched to collect systematic reviews or meta-analysis on the application of high-flow nasal cannula oxygen therapy for the patients after extubation. The retrieval time is limited to February 2020 from the time of database construction. Two researchers independently screened literature, and extracted data AMSTAR 2 scale and GRADE system were used to evaluate the methodological quality and evidence quality of the included literature.  Results  A total of 11 systematic reviews/meta-analyses were included. Eight articles compared high-flow oxygen therapy with non-invasive positive pressure ventilation and traditional oxygen therapy, and three articles compared the efficacy of high-flow oxygen therapy with traditional oxygen therapy only. The methodological quality evaluation by AMSTAR 2 was generally low, one study was low and 10 was extremely low. GRADE evaluation results showed that among the 78 evidence level outcome, 6 were high quality, 37 were intermediate quality, 29 were low quality and 6 were extremely low quality. Most studies have shown that the rate of re-intubation in patients with extubation using nasal high-flow oxygen therapy is lower than that of traditional oxygen therapy and similar to non-invasive positive pressure ventilation.  Conclusion  High-flow nasal cannula oxygen therapy can reduce the reintubation rate of patients after extubation and can be used as an alternative to non-invasive positive pressure ventilation under certain conditions. However, the quality of the methodology included in the study is low, and the quality of evidence is average. Therefore, it is recommended to carry out higher quality studies to explore the application of high-flow oxygen therapy in critically ill patients.

     

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