ArticleAnnals of intensive care2018
High-flow nasal oxygen versus noninvasive ventilation in adult patients with cystic fibrosis: a randomized crossover physiological study.
Article in Annals of intensive care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 19 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Randomized Cross-over Physiologic Study of High Flow Nasal Oxygen Cannula Versus Non-invasive Ventilation in Cystic Fibrosis. The HIFEN Study
A Pilot Study to Evaluate the Feasibility of Using High-flow Nasal Therapy During Exercise in Patients With Cystic Fibrosis and Severe Lung Disease
A Strategy to Improve Management and Prolong LIFe Without Readmission for hYpercapnic Patients: The Simplify Project
High-Flow Nasal Catheter (HFNC) Compared With Conventional Oxygenation During the Perioperative Period of Patients Undergoing Thoracic Surgery.
Who cites it
19 citing papers in PubMed, 5 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Respiratory Support in the Emergency Department: An Updated Systematic Review and Meta-Analysis.Worldviews on evidence-based nursing · 2026Pooled it
- Comparison of High Flow Nasal Therapy with Non-Invasive Ventilation and Conventional Oxygen Therapy for Acute Hypercapnic Respiratory Failure: A Meta-Analysis of Randomized Controlled Trials.International journal of chronic obstructive pulmonary disease · 2023Pooled it
- High-flow nasal cannula versus non-invasive ventilation for acute hypercapnic respiratory failure in adults: a systematic review and meta-analysis of randomized trials.Critical care (London, England) · 2022Pooled it
- High-flow nasal cannulae for respiratory support in adult intensive care patients.The Cochrane database of systematic reviews · 2021Pooled it
- High-flow nasal cannulae for respiratory support in adult intensive care patients.The Cochrane database of systematic reviews · 2017Pooled it
- Comparative Effect of High-Frequency Nasal Cannula and Noninvasive Ventilation on the Work of Breathing and Postoperative Pulmonary Complication after Pediatric Congenital Cardiac Surgery: A Prospective Randomized Controlled Trial.Annals of cardiac anaesthesia · 2024Trial
- Early nasal high-flow versus Venturi mask oxygen therapy after lung resection: a randomized trial.Critical care (London, England) · 2019Trial
- Comparison of HACOR score and ROX index for predicting noninvasive ventilation failure in acute hypoxemic respiratory failure: a prospective study.Irish journal of medical science · 2026Article
- High-flow nasal cannula versus noninvasive ventilation in stabilized hypercapnic exacerbation: a physiological crossover trial.Annals of intensive care · 2026Article
- A clinical guide to non-invasive respiratory support in acute respiratory failure: ventilation settings, technical optimization and clinical indications.Critical care (London, England) · 2025Review
- High-Flow Nasal Oxygen in Patients with Acute Hypercapnic Respiratory Failure: A Narrative Review of the Physiological Rationale and Clinical Evidence.Journal of clinical medicine · 2024Review
- Recent advances in the use of high flow nasal oxygen therapies.Frontiers in medicine · 2022Review
- Effectiveness and Harms of High-Flow Nasal Oxygen for Acute Respiratory Failure: An Evidence Report for a Clinical Guideline From the American College of Physicians.Annals of internal medicine · 2021Review
- High-flow nasal cannula oxygen therapy as an emerging option for respiratory failure: the present and the future.Therapeutic advances in chronic disease · 2020Review
- Effects of high-flow nasal cannula and non-invasive ventilation on inspiratory effort in hypercapnic patients with chronic obstructive pulmonary disease: a preliminary study.Annals of intensive care · 2019Article
- Physiological effects of high-flow oxygen in tracheostomized patients.Annals of intensive care · 2019Article
- Effect of high-flow nasal therapy on dyspnea, comfort, and respiratory rate.Critical care (London, England) · 2019Article
- High-flow oxygen therapy for the management of patients with acute exacerbation of cystic fibrosis.Annals of translational medicine · 2018Article
- New Frontiers in High-Flow Therapy.Open respiratory archivesArticle
Corrections and comments
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Authors and funding
13 authors at 9 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNoninvasive ventilation (NIV) is the first-line treatment of adult patients with exacerbations of cystic fibrosis (CF). High-flow nasal oxygen therapy (HFNT) might benefit patients with hypoxemia and can reduce physiological dead space. We hypothesized that HFNT and NIV would similarly reduce work of breathing and improving breathing pattern in CF patients. Our objective was to compare the effects of HFNT versus NIV in terms of work of breathing, assessed noninvasively by the thickening fraction of the diaphragm (TFdi, measured with ultrasound), breathing pattern, transcutaneous CO
methodsAdult CF patients who had been stabilized after requiring ventilatory support for a few days were enrolled and ventilated with HFNT and NIV for 30 min in crossover random order.
resultsFifteen patients were enrolled. Compared to baseline, HFNT, but not NIV, reduced respiratory rate (by 3 breaths/min, p = 0.01) and minute ventilation (by 2 L/min, p = 0.01). Patients also took slightly larger tidal volumes with HFNT compared to NIV (p = 0.02). TFdi per breath was similar under the two techniques and did not change from baseline. MAP increased from baseline with NIV and compared to HFNT (p ≤ 0.01). Comfort was poorer with the application of both HFNT and NIV than baseline. No differences were found for heart rate, SpO
conclusionsIn adult CF patients stabilized after indication for ventilatory support, HFNT and NIV have similar effects on diaphragmatic work per breath, but high-flow therapy confers additional physiological benefits by decreasing respiratory rate and minute ventilation. CLINICAL
trial registrationEthics Committee of St. Michael's Hospital (REB #14-338) and clinicaltrial.gov (NCT02262871).
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.