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Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) ›› 2024, Vol. 10 ›› Issue (03): 227-235. doi: 10.3877/cma.j.issn.2096-1537.2024.03.004

• Critical Care Researches • Previous Articles    

Meta-analysis of efficacy of high-flow nasal cannula oxygen therapy during endotracheal intubation in critically ill patients

Hailiang Li1, Yun Yu1, Xingxing Zhang1, Guanjie Chen1, Ling Liu1, Jianfeng Xie1, Wei Chang1,()   

  1. 1. Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
  • Received:2023-10-30 Online:2024-08-28 Published:2024-09-06
  • Contact: Wei Chang

Abstract:

Objective

To investigate the efficacy of high-flow nasal cannula oxygen (HFNC) during endotracheal intubation in critically ill patients.

Methods

Database including CNKI, VIP, Wanfang, PubMed, Cochrane Library, and Embase for randomized controlled studies on the eff icacy of continuous HFNC therapy during endotracheal intubation in critically ill patients was searched from inception to July 30, 2023. Literature screening, data extraction, and quality evaluation were independently performed by two investigators to enable statistical analysis using RevMan 5.4 software.

Results

The results of our meta-analysis showed that compared with conventional therapy, HFNC could maintain a higher pulse oxygen saturation (SpO2) during endotracheal intubation (%, MD=84, 95% CI: 0~1.68, P = 0.05), and futher a significantly shorter ICU stay (d, MD=1.8, 95% CI: 0.84~2.76, P = 0.0002); there was no significant difference in the incidence of SpO2 < 80% (OR=0.88, 95% Cl: 0.62-1.25, P = 0.49), the incidence of endotracheal intubation-related complications (OR=0.72, 95% Cl: 0.52-1.01, P = 0.06), and 28-day mortality (OR=0.76, 95% Cl: 0.55-1.05, P = 0.10) between the two groups.

Conclusion

Continuous use of HFNC during endotracheal intubation can maintain higher SpO2 and is closely related to shortened ICU stay, but more clinical studies are needed to clarify the benefits of HFNC to maintain apnoeic oxygenation in critically ill patients during endotracheal intubation.

Key words: High-flow nasal cannula oxygen, Endotracheal intubation, Apnea, Meta-analysis

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