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

Antonino Giarratano, Cesare Gregoretti, Andrea Cortegiani, Claudia Crimi, Alberto Noto, Filippo Sanfilippo, Giacomo Grasselli, Davide Di Falco, Filippo Sanfilippo

Risultato della ricerca: Article

6 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

Fingerprint

Immunocompromised Host
Nose
Respiratory Insufficiency
Meta-Analysis
Intubation
Odds Ratio
Oxygen
Therapeutics
Observational Studies
Intensive Care Units
Mortality
Group Psychotherapy
PubMed
Randomized Controlled Trials
Retrospective Studies
Research

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. / Giarratano, Antonino; Gregoretti, Cesare; Cortegiani, Andrea; Crimi, Claudia; Noto, Alberto; Sanfilippo, Filippo; Grasselli, Giacomo; Di Falco, Davide; Sanfilippo, Filippo.

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

Risultato della ricerca: Article

Giarratano, Antonino ; Gregoretti, Cesare ; Cortegiani, Andrea ; Crimi, Claudia ; Noto, Alberto ; Sanfilippo, Filippo ; Grasselli, Giacomo ; Di Falco, Davide ; Sanfilippo, Filippo. / 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.
@article{c57b39300bbf48799c71d2e66c48b3c4,
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 = "Antonino Giarratano and Cesare Gregoretti and Andrea Cortegiani and Claudia Crimi and Alberto Noto and Filippo Sanfilippo and Giacomo Grasselli and {Di Falco}, Davide and Filippo Sanfilippo",
year = "2019",
language = "English",
volume = "50",
pages = "250--256",
journal = "Journal of Critical Care",
issn = "0883-9441",
publisher = "Elsevier BV",

}

TY - JOUR

T1 - High flow nasal therapy in immunocompromised patients with acute respiratory failure: A systematic review and meta-analysis

AU - Giarratano, Antonino

AU - Gregoretti, Cesare

AU - Cortegiani, Andrea

AU - Crimi, Claudia

AU - Noto, Alberto

AU - Sanfilippo, Filippo

AU - Grasselli, Giacomo

AU - Di Falco, Davide

AU - Sanfilippo, Filippo

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.

UR - http://hdl.handle.net/10447/336474

M3 - Article

VL - 50

SP - 250

EP - 256

JO - Journal of Critical Care

JF - Journal of Critical Care

SN - 0883-9441

ER -