ReviewAnnals of intensive care2025
High flow nasal therapy versus noninvasive ventilation for AECOPD with acute hypercapnic respiratory failure: a meta-analysis of randomized controlled trials.
Review in Annals of intensive care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- High-Flow Nasal Cannula Versus Noninvasive Ventilation for Prevention of Reintubation in High-Risk Critically Ill Patients (HIGH-FLOW OXY): An Informative Systematic Review and Meta-Analysis.Critical care explorations · 2026Pooled it
- High-Flow Nasal Cannula in Hypercapnic Respiratory Failure: An Updated Systematic Review and Meta-Analysis.The clinical respiratory journal · 2026Pooled it
- Impact of High-Flow Nasal Cannula for Chronic Obstructive Pulmonary Disease Exacerbation: A Systematic Review of Clinical and Physiological Outcomes.International journal of chronic obstructive pulmonary disease · 2026Pooled it
- Explainable Machine Learning Model Based on Routine Admission Laboratory Tests for Predicting New-Onset Hypoalbuminemia in Hospitalized Older Patients with Acute Exacerbation of COPD.Clinical interventions in aging · 2026Article
- PaCOFrontiers in medicine · 2026Review
- Acute hYpErcapnic respiratory failure in The ICU: A multicenter prospective observational study - The YETI study.Annals of intensive care · 2026Article
- Efficiency of neural respiratory drive changes during non-invasive ventilation and high-flow nasal cannula oxygen therapy in AECOPD patients with acute hypercapnic respiratory failure: A randomised cross-over study.Annals of intensive care · 2026Article
- Management of hypercapnic acute respiratory failure with high-flow nasal cannula therapy: A narrative review.Annals of intensive care · 2026Review
- Clinical characteristics and economic burden of hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease in the Chinese Yi population.Frontiers in medicine · 2025Article
- High-flow nasal cannula oxygen therapy: physiological basis and clinical applications in anesthesia.Frontiers in medicine · 2025Review
- Advancing towards personalized medicine: Practical specifications for management of treatable traits in patients with COPD exacerbations.Therapeutic advances in respiratory diseaseReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGuidelines recommend the use of noninvasive ventilation (NIV) and high-flow nasal cannula (HFNC) in patients with chronic obstructive pulmonary disease (COPD) and hypercapnic acute respiratory failure (ARF). It is unclear whether HFNC is noninferior to NIV in terms of the rate of tracheal intubation or mortality. This meta-analysis aimed to compare the efficacy of HFNC and NIV in patients with AECOPD and hypercapnic ARF.
methodsA systematic search was made of PubMed, Embase, Cochrane Library, and clinicaltrials.gov, without language restrictions. Randomized controlled trials (RCTs) on treatment of hypercapnic AECOPD with HFNC, compared with NIV, were reviewed. Estimated effects of included studies were pooled as risk ratios (RRs), with 95% confidence intervals (CIs).
resultsFour RCTs (enrolling 486 patients) met the inclusion criteria. There was no statistically significant difference in all-cause mortality (RR 0.97, 95% CI 0.56 to 1.68), and intubation rate (RR 1.67, 95% CI 0.99 to 2.83) between the two groups. The treatment switch rate (RR 2.60, 95% CI 1.54 to 4.38) and treatment failure rate (RR 1.64, 95% CI 1.04 to 2.60) were significantly lower in NIV groups.
conclusionsCompared with NIV, HFNC was not associated with increased mortality and intubation rate. More patients receiving HFNC oxygen therapy experienced treatment failure and switched to NIV, which may mask the fact that HFNC is inferior to NIV in patients with AECOPD and hypercapnic ARF.
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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.