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The effects of high-flow nasal cannula on intubation and re-intubation in critically ill patients: a systematic review, meta-analysis and trial sequential analysis
OBJECTIVE: To evaluate the efficacy of high-flow nasal cannula in the prevention of intubation and re-intubation in critically ill patients compared to conventional oxygen therapy or noninvasive ventilation. METHODS: This systematic review was performed through an electronic database search of artic...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Associação de Medicina Intensiva Brasileira -
AMIB
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334477/ https://www.ncbi.nlm.nih.gov/pubmed/30672973 http://dx.doi.org/10.5935/0103-507X.20180070 |
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author | Bocchile, Rafael Ladeira Rosa Cazati, Denise Carnieli Timenetsky, Karina Tavares Serpa Neto, Ary |
author_facet | Bocchile, Rafael Ladeira Rosa Cazati, Denise Carnieli Timenetsky, Karina Tavares Serpa Neto, Ary |
author_sort | Bocchile, Rafael Ladeira Rosa |
collection | PubMed |
description | OBJECTIVE: To evaluate the efficacy of high-flow nasal cannula in the prevention of intubation and re-intubation in critically ill patients compared to conventional oxygen therapy or noninvasive ventilation. METHODS: This systematic review was performed through an electronic database search of articles published from 1966 to April 2018. The primary outcome was the need for intubation or re-intubation. The secondary outcomes were therapy escalation, mortality at the longest follow-up, hospital mortality and the need for noninvasive ventilation. RESULTS: Seventeen studies involving 3,978 patients were included. There was no reduction in the need for intubation or re-intubation with high-flow nasal cannula (OR 0.72; 95%CI 0.52 - 1.01; p = 0.056). There was no difference in the need for therapy escalation (OR 0.80, 95% CI 0.59 - 1.08, p = 0.144), mortality at the longest follow-up (OR 0.94; 95%CI 0.70 - 1.25; p = 0.667), hospital mortality (OR 0.84; 95%CI 0.56 - 1.26; p = 0.391) or noninvasive ventilation (OR 0.64, 95%CI 0.39 - 1.05, p = 0.075). In the trial sequential analysis, the number of events included was lower than the optimal information size with a global type I error > 0.05. CONCLUSION: In the present study and setting, high-flow nasal cannula was not associated with a reduction of the need for intubation or re-intubation in critically ill patients. |
format | Online Article Text |
id | pubmed-6334477 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Associação de Medicina Intensiva Brasileira -
AMIB |
record_format | MEDLINE/PubMed |
spelling | pubmed-63344772019-01-24 The effects of high-flow nasal cannula on intubation and re-intubation in critically ill patients: a systematic review, meta-analysis and trial sequential analysis Bocchile, Rafael Ladeira Rosa Cazati, Denise Carnieli Timenetsky, Karina Tavares Serpa Neto, Ary Rev Bras Ter Intensiva Review Article OBJECTIVE: To evaluate the efficacy of high-flow nasal cannula in the prevention of intubation and re-intubation in critically ill patients compared to conventional oxygen therapy or noninvasive ventilation. METHODS: This systematic review was performed through an electronic database search of articles published from 1966 to April 2018. The primary outcome was the need for intubation or re-intubation. The secondary outcomes were therapy escalation, mortality at the longest follow-up, hospital mortality and the need for noninvasive ventilation. RESULTS: Seventeen studies involving 3,978 patients were included. There was no reduction in the need for intubation or re-intubation with high-flow nasal cannula (OR 0.72; 95%CI 0.52 - 1.01; p = 0.056). There was no difference in the need for therapy escalation (OR 0.80, 95% CI 0.59 - 1.08, p = 0.144), mortality at the longest follow-up (OR 0.94; 95%CI 0.70 - 1.25; p = 0.667), hospital mortality (OR 0.84; 95%CI 0.56 - 1.26; p = 0.391) or noninvasive ventilation (OR 0.64, 95%CI 0.39 - 1.05, p = 0.075). In the trial sequential analysis, the number of events included was lower than the optimal information size with a global type I error > 0.05. CONCLUSION: In the present study and setting, high-flow nasal cannula was not associated with a reduction of the need for intubation or re-intubation in critically ill patients. Associação de Medicina Intensiva Brasileira - AMIB 2018 /pmc/articles/PMC6334477/ /pubmed/30672973 http://dx.doi.org/10.5935/0103-507X.20180070 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Bocchile, Rafael Ladeira Rosa Cazati, Denise Carnieli Timenetsky, Karina Tavares Serpa Neto, Ary The effects of high-flow nasal cannula on intubation and re-intubation in critically ill patients: a systematic review, meta-analysis and trial sequential analysis |
title | The effects of high-flow nasal cannula on intubation and
re-intubation in critically ill patients: a systematic review, meta-analysis and
trial sequential analysis |
title_full | The effects of high-flow nasal cannula on intubation and
re-intubation in critically ill patients: a systematic review, meta-analysis and
trial sequential analysis |
title_fullStr | The effects of high-flow nasal cannula on intubation and
re-intubation in critically ill patients: a systematic review, meta-analysis and
trial sequential analysis |
title_full_unstemmed | The effects of high-flow nasal cannula on intubation and
re-intubation in critically ill patients: a systematic review, meta-analysis and
trial sequential analysis |
title_short | The effects of high-flow nasal cannula on intubation and
re-intubation in critically ill patients: a systematic review, meta-analysis and
trial sequential analysis |
title_sort | effects of high-flow nasal cannula on intubation and
re-intubation in critically ill patients: a systematic review, meta-analysis and
trial sequential analysis |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334477/ https://www.ncbi.nlm.nih.gov/pubmed/30672973 http://dx.doi.org/10.5935/0103-507X.20180070 |
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