High flow nasal therapy in immunocompromised patients with acute respiratory failure: A systematic review and meta-analysis

Crimi, C.; Sanfilippo, F.; Noto, A.; Di Falco, D.; Grasselli, G.

Risultato della ricerca: Article

5 Citazioni (Scopus)

Abstract

Purpose: The role of high-flow nasal therapy (HFNT) as compared to conventional oxygen therapy (COT) in immunocompromised patients admitted to intensive care unit (ICU) with acute respiratory failure (ARF) remains unclear. We conducted a systematic review and meta-analysis in order to address this issue. Methods: We searched PubMed, Medline and Embase until November 7th, 2018. Randomized controlled trials (RCTs), non-randomized prospective and retrospective evidence were selected. Observational studies were considered for sensitivity analysis. Primary outcome was mortality rate; intubation rate was a secondary outcome. Results: We included four studies in the primary analysis: one RCT, two RCT's post-hoc analyses and one retrospective study. We found no significant difference in short-term mortality comparing HFNT vs. COT: 1) ICU: n = 872 patients, odds ratio (OR) = 0.80 [0.44,1.45], p = 0.46, I2 = 30%, p = 0.24; 2) 28-day: n = 996 patients, OR = 0.79 [0.45,1.38], p = 0.40, I2 = 52%, p = 0.12). Conversely, we found a reduction of intubation rate in the HFNT group (n = 1052 patients, OR = 0.74 [0.55,0.98], p = 0.03, I2 = 7%, p = 0.36). The inclusion of one observational study for sensitivity analysis did not grossly change results. Conclusions: We found no benefit of HFNT over COT on mortality in immunocompromised patients with ARF. However, HFNT was associated with a lower intubation rate warranting further research.
Lingua originaleEnglish
pagine (da-a)250-256
Numero di pagine7
RivistaJournal of Critical Care
Volume50
Stato di pubblicazionePublished - 2019

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cita questo

High flow nasal therapy in immunocompromised patients with acute respiratory failure: A systematic review and meta-analysis. / Crimi, C.; Sanfilippo, F.; Noto, A.; Di Falco, D.; Grasselli, G.

In: Journal of Critical Care, Vol. 50, 2019, pag. 250-256.

Risultato della ricerca: Article

Crimi, C.; Sanfilippo, F.; Noto, A.; Di Falco, D.; Grasselli, G. 2019, 'High flow nasal therapy in immunocompromised patients with acute respiratory failure: A systematic review and meta-analysis', Journal of Critical Care, vol. 50, pagg. 250-256.
Crimi, C.; Sanfilippo, F.; Noto, A.; Di Falco, D.; Grasselli, G. / High flow nasal therapy in immunocompromised patients with acute respiratory failure: A systematic review and meta-analysis. In: Journal of Critical Care. 2019 ; Vol. 50. pagg. 250-256.
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title = "High flow nasal therapy in immunocompromised patients with acute respiratory failure: A systematic review and meta-analysis",
abstract = "Purpose: The role of high-flow nasal therapy (HFNT) as compared to conventional oxygen therapy (COT) in immunocompromised patients admitted to intensive care unit (ICU) with acute respiratory failure (ARF) remains unclear. We conducted a systematic review and meta-analysis in order to address this issue. Methods: We searched PubMed, Medline and Embase until November 7th, 2018. Randomized controlled trials (RCTs), non-randomized prospective and retrospective evidence were selected. Observational studies were considered for sensitivity analysis. Primary outcome was mortality rate; intubation rate was a secondary outcome. Results: We included four studies in the primary analysis: one RCT, two RCT's post-hoc analyses and one retrospective study. We found no significant difference in short-term mortality comparing HFNT vs. COT: 1) ICU: n = 872 patients, odds ratio (OR) = 0.80 [0.44,1.45], p = 0.46, I2 = 30{\%}, p = 0.24; 2) 28-day: n = 996 patients, OR = 0.79 [0.45,1.38], p = 0.40, I2 = 52{\%}, p = 0.12). Conversely, we found a reduction of intubation rate in the HFNT group (n = 1052 patients, OR = 0.74 [0.55,0.98], p = 0.03, I2 = 7{\%}, p = 0.36). The inclusion of one observational study for sensitivity analysis did not grossly change results. Conclusions: We found no benefit of HFNT over COT on mortality in immunocompromised patients with ARF. However, HFNT was associated with a lower intubation rate warranting further research.",
author = "{Crimi, C.; Sanfilippo, F.; Noto, A.; Di Falco, D.; Grasselli, G.} and Antonino Giarratano and Andrea Cortegiani and Cesare Gregoretti",
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AU - Crimi, C.; Sanfilippo, F.; Noto, A.; Di Falco, D.; Grasselli, G.

AU - Giarratano, Antonino

AU - Cortegiani, Andrea

AU - Gregoretti, Cesare

PY - 2019

Y1 - 2019

N2 - Purpose: The role of high-flow nasal therapy (HFNT) as compared to conventional oxygen therapy (COT) in immunocompromised patients admitted to intensive care unit (ICU) with acute respiratory failure (ARF) remains unclear. We conducted a systematic review and meta-analysis in order to address this issue. Methods: We searched PubMed, Medline and Embase until November 7th, 2018. Randomized controlled trials (RCTs), non-randomized prospective and retrospective evidence were selected. Observational studies were considered for sensitivity analysis. Primary outcome was mortality rate; intubation rate was a secondary outcome. Results: We included four studies in the primary analysis: one RCT, two RCT's post-hoc analyses and one retrospective study. We found no significant difference in short-term mortality comparing HFNT vs. COT: 1) ICU: n = 872 patients, odds ratio (OR) = 0.80 [0.44,1.45], p = 0.46, I2 = 30%, p = 0.24; 2) 28-day: n = 996 patients, OR = 0.79 [0.45,1.38], p = 0.40, I2 = 52%, p = 0.12). Conversely, we found a reduction of intubation rate in the HFNT group (n = 1052 patients, OR = 0.74 [0.55,0.98], p = 0.03, I2 = 7%, p = 0.36). The inclusion of one observational study for sensitivity analysis did not grossly change results. Conclusions: We found no benefit of HFNT over COT on mortality in immunocompromised patients with ARF. However, HFNT was associated with a lower intubation rate warranting further research.

AB - Purpose: The role of high-flow nasal therapy (HFNT) as compared to conventional oxygen therapy (COT) in immunocompromised patients admitted to intensive care unit (ICU) with acute respiratory failure (ARF) remains unclear. We conducted a systematic review and meta-analysis in order to address this issue. Methods: We searched PubMed, Medline and Embase until November 7th, 2018. Randomized controlled trials (RCTs), non-randomized prospective and retrospective evidence were selected. Observational studies were considered for sensitivity analysis. Primary outcome was mortality rate; intubation rate was a secondary outcome. Results: We included four studies in the primary analysis: one RCT, two RCT's post-hoc analyses and one retrospective study. We found no significant difference in short-term mortality comparing HFNT vs. COT: 1) ICU: n = 872 patients, odds ratio (OR) = 0.80 [0.44,1.45], p = 0.46, I2 = 30%, p = 0.24; 2) 28-day: n = 996 patients, OR = 0.79 [0.45,1.38], p = 0.40, I2 = 52%, p = 0.12). Conversely, we found a reduction of intubation rate in the HFNT group (n = 1052 patients, OR = 0.74 [0.55,0.98], p = 0.03, I2 = 7%, p = 0.36). The inclusion of one observational study for sensitivity analysis did not grossly change results. Conclusions: We found no benefit of HFNT over COT on mortality in immunocompromised patients with ARF. However, HFNT was associated with a lower intubation rate warranting further research.

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JO - Journal of Critical Care

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