• Yue-Nan Ni, Jian Luo, He Yu, Dan Liu, Bin-Miao Liang, Rong Yao, and Zong-An Liang.
• Department of Respiratory and Critical Care, Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, China.
• BMC Pulm Med. 2017 Nov 17; 17 (1): 142.

BackgroundThe effects of high flow nasal cannula (HFNC) on adult patients after extubation remain controversial. We aimed to further determine the effectiveness of HFNC in comparison to noninvasive positive pressure ventilation (NIPPV) and conventional oxygen therapy (COT).MethodsThe Pubmed, Embase, Medline, Cochrane Central Register of Controlled Trails (CENTRAL) as well as the Information Sciences Institute (ISI) Web of Science were searched for all the controlled study comparing HFNC with NIPPV and COT in adult patients after extubation. The primary outcome was rate of reintubation and the secondary outcomes were intensive care unit (ICU) mortality and length of ICU stay (ICU LOS).ResultsEight trials with a total of 2936 patients were pooled in our final studies. No significant heterogeneity was found in outcome measures. Compared with COT, HFNC was associated with lower rate of reintubation (Z = 2.97, P = 0.003), and the same result was found in the comparison between HFNC and NIPPV (Z = 0.87, P = 0.38). As for the ICU mortality and ICU LOS, we did not find any advantage of HFNC over COT or NIPPV.ConclusionsIn patients after extubation, HFNC is a reliable alternative of NIPPV to reduce rate of reintubation compared with COT.

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