Evidence map›Paper›PMID 35428349›Full record

Trial reportCritical care (London, England)2022

High-flow nasal cannula versus conventional oxygen therapy in acute COPD exacerbation with mild hypercapnia: a multicenter randomized controlled trial.

Jingen Xia, Sichao Gu, Wei Lei, Jihua Zhang, Hui Wei, Chao Liu, Han Zhang, Rongli Lu, Liqiong Zhang, Mingyan Jiang and 24 more

Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03003559 (Comparison of High Flow Nasal Cannula vs Nasal Cannula in Mild Chronic Obstructive Pulmonary Disease Exacerbation), which is not on this map. Cited by 29 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 7 pooled it
7.4field-weighted citation impact, top 2% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT03003559 naunknown statusnot on this map

Comparison of High Flow Nasal Cannula vs Nasal Cannula in Mild Chronic Obstructive Pulmonary Disease Exacerbation(AECOPD)

TypeinterventionalSponsorChina-Japan Friendship HospitalRan2017 to 2020Enrolled328ConditionsCOPD ExacerbationArmsHigh flow nasal cannula
3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 7 syntheses or guidelines pooled it, 53 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

34 authors at 19 institutions in 1 country.

Jingen Xia *Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, Beijing, 100029, China.
Sichao Gu *Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, Beijing, 100029, China.
Wei Lei *Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China.
Jihua Zhang *Department of Pulmonary and Critical Care Medicine, The People's Hospital of Yuxi City, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China.
Hui WeiDepartment of Pulmonary and Critical Care Medicine, Inner Mongolia People's Hospital, No. 20 Zhaowuda Road, Hohhot, 010017, China.
Chao LiuDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China.
Han ZhangDepartment of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, No.139 Renmin Middle Road, Changsha, 410011, China.
Rongli LuDepartment of Pulmonary and Critical Care Medicine, Xiangya Hospital, Central South University, No.87 Xiangya Road, Changsha, 410008, China.
Liqiong ZhangDepartment of Pulmonary and Critical Care Medicine, The People's Hospital of Yuxi City, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China.
Mingyan JiangDepartment of Pulmonary and Critical Care Medicine, Xiangtan Central Hospital, Xiangtan, China.
Chao HuDepartment of Pulmonary and Critical Care Medicine, Xiangtan Central Hospital, Xiangtan, China.
Zhenshun ChengDepartment of Pulmonary and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
Chaojie WeiDepartment of Pulmonary and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
Yusheng ChenDepartment of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, China.
Fengfeng LuDepartment of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, China.
Min ChenDepartment of Pulmonary and Critical Care Medicine, Calmette Hospital and The First Hospital of Kunming, Kunming, China.
Hong BiDepartment of Pulmonary and Critical Care Medicine, Calmette Hospital and The First Hospital of Kunming, Kunming, China.
Hui LiuDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Cunzi YanDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Hong TengDepartment of Pulmonary and Critical Care Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Yang YangDepartment of Pulmonary and Critical Care Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Chen LiangChinese Alliance for Respiratory Diseases in Primary Care, Beijing, China.
Yanlei GeDepartment of Pulmonary and Critical Care Medicine, North China University of Science and Technology Affiliated Hospital, Tangshan, China.
Pengguo HouDepartment of Pulmonary and Critical Care Medicine, The Third People's Hospital of Datong, Datong, China.
Jialin LiuDepartment of Critical Care Medicine, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
Weiwei GaoDepartment of Respiratory Medicine, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Yi ZhangDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, Beijing, 100029, China.
Yingying FengDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, Beijing, 100029, China.
Cheng TaoDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, Beijing, 100029, China.
Xu HuangDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, Beijing, 100029, China.
Pinhua PanDepartment of Pulmonary and Critical Care Medicine, Xiangya Hospital, Central South University, No.87 Xiangya Road, Changsha, 410008, China. pinhuapan668@csu.edu.cn.
Hong LuoDepartment of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, No.139 Renmin Middle Road, Changsha, 410011, China. luohonghuxi@csu.edu.cn.
Chunmei YunDepartment of Pulmonary and Critical Care Medicine, Inner Mongolia People's Hospital, No. 20 Zhaowuda Road, Hohhot, 010017, China. 1979471693@qq.com.
Qingyuan ZhanDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang District, Beijing, 100029, China. drzhanqy@163.com.
National Clinical Research Center for Digestive Diseases · CNChina-Japan Friendship Hospital · CNChinese Academy of Medical Sciences & Peking Union Medical College · CNFirst Affiliated Hospital of Soochow University · CNFujian Provincial Hospital · CNInner Mongolia People's Hospital · CNSixth Affiliated Hospital of Kunming Medical University · CNThe First Hospital of Kunming · CNUniversity of Electronic Science and Technology of China · CNXiangya Hospital Central South University · CNXiangyang Central Hospital · CNXinjiang Medical University · CNCentral South University · CNNorth China University of Science and Technology Affiliated Hospital · CNSecond Affiliated Hospital of Zhengzhou University · CNSecond Xiangya Hospital of Central South University · CNShanghai Jiao Tong University · CNWuhan Center for Disease Control and Prevention · CNWuhan University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigh-flow nasal cannula (HFNC) can improve ventilatory function in patients with acute COPD exacerbation. However, its effect on clinical outcomes remains uncertain.

methodsThis randomized controlled trial was conducted from July 2017 to December 2020 in 16 tertiary hospitals in China. Patients with acute COPD exacerbation with mild hypercapnia (pH ≥ 7.35 and arterial partial pressure of carbon dioxide > 45 mmHg) were randomly assigned to either HFNC or conventional oxygen therapy. The primary outcome was the proportion of patients who met the criteria for intubation during hospitalization. Secondary outcomes included treatment failure (intolerance and need for non-invasive or invasive ventilation), length of hospital stay, hospital cost, mortality, and readmission at day 90.

resultsAmong 337 randomized patients (median age, 70.0 years; 280 men [83.1%]; median pH 7.399; arterial partial pressure of carbon dioxide 51 mmHg), 330 completed the trial. 4/158 patients on HFNC and 1/172 patient on conventional oxygen therapy met the criteria for intubation (P = 0.198). Patients progressed to NPPV in both groups were comparable (15 [9.5%] in the HFNC group vs. 22 [12.8%] in the conventional oxygen therapy group; P = 0.343). Compared with conventional oxygen therapy, HFNC yielded a significantly longer median length of hospital stay (9.0 [interquartile range, 7.0-13.0] vs. 8.0 [interquartile range, 7.0-11.0] days) and a higher median hospital cost (approximately $2298 [interquartile range, $1613-$3782] vs. $2005 [interquartile range, $1439-$2968]). There were no significant differences in other secondary outcomes between groups.

conclusionsIn this multi-center randomized controlled study, HFNC compared to conventional oxygen therapy did not reduce need for intubation among acute COPD exacerbation patients with mild hypercapnia. The future studies should focus on patients with acute COPD exacerbation with respiratory acidosis (pH < 7.35). However, because the primary outcome rate was well below expected, the study was underpowered to show a meaningful difference between the two treatment groups.

trial registrationNCT03003559 . Registered on December 28, 2016.

Indexed as

Noninvasive VentilationPulmonary Disease, Chronic ObstructiveRespiratory InsufficiencyAgedCannulaCarbon DioxideFemaleHumansHypercapniaMaleOxygenOxygen Inhalation TherapyCarbon DioxideOxygenChronic obstructiveHigh-flow nasal cannulaHypercapniaPulmonary diseaseRespiratory insufficiencyRespiratory support

Identifiers

PMID35428349
PMCPMC9013098
OpenAlexW4223927566

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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.