• Mingxu Zheng, Liangliang Dong, Zerui Hao, and Shuyun Wang.
• Department of respiratory, Liaocheng Second People's Hospital, Liaocheng, Shandong, China.
• Medicine (Baltimore). 2021 Apr 16; 100 (15): e25489e25489.

BackgroundPresently, there are no reviews or meta-analyses comparing the efficacy and safety of high-flow oxygen therapy (HFOT) and noninvasive ventilation (NIV) as first-line treatment in exacerbated chronic obstructive pulmonary disease (COPD) patients. The present protocol is conceived to evaluate whether HFOT is noninferior to NIV in treatment of patients with COPD and acute hypercapnic respiratory failure.MethodsWe will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines and the recommendations of the Cochrane Collaboration to conduct this meta-analysis. Reviewers will search the PubMed, Cochrane Library, Web of Science, and EMBASE online databases using the key phrases "high-flow oxygen therapy," "chronic obstructive pulmonary disease," and "acute hypercapnic respiratory failure" for all English-language cohort studies published up to April, 2021. The cohort studies focusing on assess the efficacy and safety of HFOT and NIV in the treatment of patients with COPD and acute hypercapnic respiratory failure will be included in our meta-analysis. The primary outcome is treatment failure, whereas the secondary outcomes included arterial blood gas analysis, dyspnea score, comfort score, mortality, and total ICU and hospital lengths of stay.ResultsThe trial is conducted to test the hypothesis that HFOT, administered immediately after extubation, is not inferior to the NIV in reducing the rate of treatment failure in patients with COPD who were previously intubated due to hypercapniac respiratory failure.Registration Number10.17605/OSF.IO/Z2PEJ.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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