Cited by 112Respiratory Support and MechanismsAirway Management and Intubation TechniquesNeonatal Respiratory Health Research

The effect of high-flow nasal cannula in reducing the mortality and the rate of endotracheal intubation when used before mechanical ventilation compared with conventional oxygen therapy and noninvasive positive pressure ventilation. A systematic review and meta-analysis

Ni, Yue-Nan, Luo, Jian, Yu, He, Liu, Dan, Liang, Bin-Miao, Liang, Zong-An·2018·The American Journal of Emergency Medicine

Abstract

Background The effects of high flow nasal cannula (HFNC) on adult patients when used before mechanical ventilation (MV) are unclear. We aimed to determine the effectiveness of HFNC when used before MV by comparison to conventional oxygen therapy (COT) and noninvasive positive pressure ventilation (NIPPV).Methods The Pubmed, Embase, Medline, Cochrane Central Register of Controlled Trials (CENTRAL) as well as the Information Sciences Institute (ISI) Web of Science were searched for all the controlled studies that compared HFNC with NIPPV and COT when used before MV in adult patients. The primary outcome was the rate of endotracheal intubation and the secondary outcomes were intensive care unit (ICU) mortality and length of ICU stay (ICU LOS).Results Eight trials with a total of 1084 patients were pooled in our final studies. No significant heterogeneity was found in outcome measures. Compared both with COT and NIPPV, HFNC could reduce both of the rate of endotracheal intubation (OR 0.62, 95% CI 0.38-0.99, P=0.05; OR 0.48, 95% CI 0.31-0.73, P=0.0006) and ICU mortality (OR 0.47, 95% CI 0.24-0.93, P=0.03; OR 0.36, 95% CI 0.20-0.63, P=0.0004). As for the ICU LOS, we did not find any advantage of HFNC over COT or NIPPV.Conclusions When used before MV, HFNC can improve the prognosis of patients compared both with the COT and NIPPV.

Integrity signals

Registry

Crossref · 10.1016/j.ajem.2017.07.083

Cites

58 of 58 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A systematic review and meta-analysis of nine RCTs showed that HFNC reduces intubation compared with conventional oxygen (RR 0.85; 95% CI 0.74-0.99) but does not affect the risk of death or ICU length of stay.

    “A systematic review and meta-analysis of nine RCTs [2] showed that HFNC reduces intubation compared with conventional oxygen (RR 0.85; 95% CI 0.74–0.99) but does not affect the risk of death or ICU length of stay [412–414].”

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Ni, Y.-N., Luo, J., Yu, H., Liu, D., Liang, B.-M., & Liang, Z.-A.
Affiliations
Sichuan University (CN)
Corresponding author
Liang, Zong-An
Venue
The American Journal of Emergency Medicine
Publisher
Elsevier BV
Published
2018-02
Volume
36
Issue
2
Pages
226-233
ISSN
0735-6757 (ISSN-L)
OpenAlex
W2739506637
Cited by
112
References
58
Citations by year
2026: 3 · 2025: 5 · 2024: 4 · 2023: 11 · 2022: 16 · 2021: 24 · 2020: 39 · 2019: 6 · 2018: 3 · 2017: 1
FWCI
2.44
Type
journal article
Language
en
Open access
closed
Locations
  • The American Journal of Emergency Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Sichuan Science and Technology Agency (2014SZ0010)
  • National Natural Science Foundation of China (81600057)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
Keywords
high-flow nasal cannula, endotracheal intubation, ICU mortality, ICU length of stay, noninvasive positive pressure ventilation, conventional oxygen therapy, mechanical ventilation, adult patients
MeSH terms
Cannula, Clinical Trials as Topic, Critical Care, Humans, Intubation, Intratracheal, Oxygen Inhalation Therapy, Positive-Pressure Respiration, Respiration, Artificial

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review