SynthesisBMJ open respiratory research2024
High-flow nasal oxygen therapy compared with conventional oxygen therapy in hospitalised patients with respiratory illness: a systematic review and meta-analysis.
Synthesis in BMJ open respiratory research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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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.
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Who cites it
16 citing papers in PubMed.
- Efficacy of nasal high-flow therapy versus standard oxygen therapy in hypoxemic respiratory failure: a systematic review and meta-analysis of RCTS.Annals of medicine and surgery (2012) · 2026Article
- Practical considerations of ward-based high-flow nasal oxygen therapy for hypoxaemic respiratory failure.Internal medicine journal · 2026Article
- PaCOJournal of clinical medicine · 2026Review
- Use of nasal high-flow in emergency departments: a four-nation UK-wide survey.Emergency medicine journal : EMJ · 2026Article
- Prescription and use of ward-delivered nasal high-flow oxygen and non-invasive ventilation for people with acute respiratory failure.Internal medicine journal · 2026Article
- High-Flow Nasal Cannula in Patients Awaiting Lung Transplant: Evidence, Clinical Applications, and Outcomes.Advances in respiratory medicine · 2026Review
- High-flow nasal therapy vs conventional oxygen therapy in mild COVID-19 hypoxaemia: a Bayesian reanalysis of the COVID-HIGH Trial.Journal of anesthesia, analgesia and critical care · 2026Article
- PaCOFrontiers in medicine · 2026Review
- Advances in mechanical ventilation for critically ill patients: strategies for respiratory support and complication management.American journal of translational research · 2026Review
- Improving internal medicine resident proficiency in non-invasive positive pressure ventilation and oxygen modalities through simulation training.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2026Article
- Ward-Based High-Flow Nasal Cannula Led by the Medical Emergency Team: A Pragmatic Model for Resource Stewardship.Critical care explorations · 2025Article
- Debunking a one-size-fits-all in acute respiratory failure: lessons from the RENOVATE trial.Journal of thoracic disease · 2025Article
- Ward-delivered nasal high-flow oxygen and non-invasive ventilation are safe for people with acute respiratory failure: a cohort study.Internal medicine journal · 2025Article
- Management of Asthma and COPD Exacerbations in Adults in the ICU.CHEST critical care · 2025Article
- Observational
- Key lessons from the COVID-19 pandemic: Role of intensive care, politics and science communication (Review).Medicine internationalArticle
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh-flow nasal oxygen therapy (HFNO) is used in diverse hospital settings to treat patients with acute respiratory failure (ARF). This systematic review aims to summarise the evidence regarding any benefits HFNO therapy has compared with conventional oxygen therapy (COT) for patients with ARF.
methodsThree databases (Embase, Medline and CENTRAL) were searched on 22 March 2023 for studies evaluating HFNO compared with COT for the treatment of ARF, with the primary outcome being hospital mortality and secondary outcomes including (but not limited to) escalation to invasive mechanical ventilation (IMV) or non-invasive ventilation (NIV). Risk of bias was assessed using the Cochrane risk-of-bias tool (randomised controlled trials (RCTs)), ROBINS-I (non-randomised trials) or Newcastle-Ottawa Scale (observational studies). RCTs and observational studies were pooled together for primary analyses, and secondary analyses used RCT data only. Treatment effects were pooled using the random effects model.
results63 studies (26 RCTs, 13 cross-over and 24 observational studies) were included, with 10 230 participants. There was no significant difference in the primary outcome of hospital mortality (risk ratio, RR 1.08, 95% CI 0.93 to 1.26; p=0.29; 17 studies, n=5887) between HFNO and COT for all causes ARF. However, compared with COT, HFNO significantly reduced the overall need for escalation to IMV (RR 0.85, 95% CI 0.76 to 0.95 p=0.003; 39 studies, n=8932); and overall need for escalation to NIV (RR 0.70, 95% CI 0.50 to 0.98; p=0.04; 16 studies, n=3076). In subgroup analyses, when considering patients by illness types, those with acute-on-chronic respiratory failure who received HFNO compared with COT had a significant reduction in-hospital mortality (RR 0.58, 95% CI 0.37 to 0.91; p=0.02). DISCUSSION: HFNO was superior to COT in reducing the need for escalation to both IMV and NIV but had no impact on the primary outcome of hospital mortality. These findings support recommendations that HFNO may be considered as first-line therapy for ARF. PROSPERO REGISTRATION NUMBER: CRD42021264837.
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