Abdelbaky Ahmed M, Elmasry Wael G, Awad Ahmed H, Khan Sarrosh, Jarrahi Maryam
Intensive Care Unit, Dubai Academic Health Corporation - Rashid Hospital, Dubai, ARE.
Internal Medicine, Dubai Academic Health Corporation - Rashid Hospital, Dubai, ARE.
Cureus. 2023 Jun 30;15(6):e41219. doi: 10.7759/cureus.41219. eCollection 2023 Jun.
High-flow nasal cannula (HFNC) is a novel oxygenation approach in the management of acute respiratory distress syndrome (ARDS). This systematic review was focused on evaluating current evidence concerning the efficacy of HFNC in ARDS and its comparison with standard treatment approaches. For this review, a systematic search was undertaken in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Web of Science, Cochrane Library, and Google Scholar to identify relevant studies. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. All those studies that investigated the impact of HFNC on ARDS patients and were published in the English language were included. The literature search from all databases provided 6157 potentially relevant articles from PubMed (n = 1105), CINAHL (n = 808), Web of Science (n = 811), Embase (n = 2503), Cochrane database (n = 930), and Google Scholar (n = 46). After the exclusion of studies that did not fulfill the criteria, 18 studies were shortlisted for the scope of this systematic review. Among the included studies, five focused on HFNC's impact on COVID-19-related ARDS, whereas 13 studies focused on HFNC's impact on ARDS patients. Most studies demonstrated the efficacy of HFNC in managing ARDS, with some studies showing comparable efficacy and higher safety compared to noninvasive ventilation (NIV). This systematic review highlights the potential benefits of HFNC in ARDS management. The findings show that HFNC is effective in reducing the respiratory distress symptoms, the incidence of invasive ventilation, and the adverse events associated with ARDS. These findings can help clinical decision-making processes and contribute to the evidence base for optimal ARDS management strategies.
高流量鼻导管吸氧（HFNC）是治疗急性呼吸窘迫综合征（ARDS）的一种新型氧合方法。本系统评价旨在评估有关HFNC治疗ARDS疗效的现有证据及其与标准治疗方法的比较。为此评价，我们在PubMed、护理学与健康相关文献累积索引（CINAHL）、Embase、科学网、考克兰图书馆和谷歌学术中进行了系统检索，以识别相关研究。遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。纳入所有调查HFNC对ARDS患者影响且以英文发表的研究。来自所有数据库的文献检索共提供了6157篇可能相关的文章，其中PubMed有1105篇、CINAHL有808篇、科学网有811篇、Embase有2503篇、考克兰数据库有930篇、谷歌学术有46篇。在排除不符合标准的研究后，18项研究被列入本系统评价的范围。在纳入的研究中，5项聚焦于HFNC对新型冠状病毒肺炎相关ARDS的影响，而13项研究聚焦于HFNC对ARDS患者的影响。大多数研究证明了HFNC治疗ARDS的疗效，一些研究表明与无创通气（NIV）相比，其疗效相当且安全性更高。本系统评价强调了HFNC在ARDS治疗中的潜在益处。研究结果表明，HFNC可有效减轻呼吸窘迫症状、有创通气发生率以及与ARDS相关的不良事件。这些研究结果有助于临床决策过程，并为优化ARDS管理策略的证据基础做出贡献。
