高流量鼻导管在慢性阻塞性肺疾病急性加重期的应用：系统评价和荟萃分析。
High-flow nasal cannula for acute exacerbation of chronic obstructive pulmonary disease: A systematic review and meta-analysis.
机构信息
Graduate school of Dalian Medical University, Dalian, Liaoning province, China; Department of Critical Care Medicine, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China.
Department of Critical Care Medicine, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China; Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu Province, China.
出版信息
Heart Lung. 2021 Mar-Apr;50(2):252-261. doi: 10.1016/j.hrtlng.2020.12.010. Epub 2020 Dec 22.
BACKGROUND
The evidence for the safety of high-flow nasal cannula (HFNC) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients is conflicting.
OBJECTIVES
To evaluate the intubation and mortality risks of HFNC compared to non-invasive ventilation (NIV) and conventional oxygen therapy (COT) for AECOPD patients.
METHODS
A search of electronic databases was performed. Studies that used HFNC to treat AECOPD patients were identified.
RESULTS
Seven RCTs and one observational study were included. There were no differences in intubation risk (risk ratio (RR) 0.94, 95% confidence interval (CI) 0.49 to 1.78, p = 0.84, very low certainty) and mortality risk (RR 0.91, 95% CI 0.46 to 1.79, p = 0.77, very low certainty) for HFNC compared with NIV. No data were available for intubation or mortality risk for HFNC compared with COT.
CONCLUSION
For AECOPD patients, low-quality evidence indicates that HFNC does not increase intubation and mortality risks compared to NIV.
背景
高流量鼻导管（HFNC）在慢性阻塞性肺疾病急性加重（AECOPD）患者中的安全性证据存在争议。
目的
评估与无创通气（NIV）和常规氧疗（COT）相比，HFNC 治疗 AECOPD 患者的插管和死亡率风险。
方法
对电子数据库进行了检索。确定了使用 HFNC 治疗 AECOPD 患者的研究。
结果
纳入了 7 项 RCT 和 1 项观察性研究。HFNC 与 NIV 相比，插管风险（风险比（RR）0.94，95%置信区间（CI）0.49 至 1.78，p=0.84，极低确定性）和死亡率风险（RR 0.91，95%CI 0.46 至 1.79，p=0.77，极低确定性）无差异。HFNC 与 COT 相比，尚无关于插管或死亡率风险的数据。
结论
对于 AECOPD 患者，低质量证据表明 HFNC 与 NIV 相比，不会增加插管和死亡率风险。
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