SynthesisCritical care science2026
The efficacy of high-flow nasal cannula versus non-invasive mechanical ventilation in preventing reintubation in patients at high risk of extubation failure: systematic review and meta-analysis with trial sequential analysis.
Synthesis in Critical care science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo conduct a systematic review and meta-analysis with trial sequential analysis to compare the efficacy of high-flow nasal cannula versus noninvasive ventilation in preventing reintubation, post-extubation respiratory failure, mortality, and length of stay in intensive care unit and hospital in patients at high risk of extubation failure.
methodsA comprehensive literature search was conducted across ten databases: MEDLINE®/PubMed®, Web of Science, SciELO, Embase, Scopus, the Cochrane Central Register of Controlled Trials, the International Clinical Trials Registry Platform, Google Scholar, GreyNet International, and OpenGrey. The primary outcome was reintubation. Secondary outcomes included post-extubation respiratory failure, intensive care unit and hospital mortality, as well as intensive care unit and hospital length of stay.
resultsTen randomized controlled trials comprising 1,697 patients were included. There were no significant differences between high-flow nasal cannula and non-invasive ventilation in reintubation (RR = 1.00; 95%CI 0.92 - 1.09; p = 0.92; I2 = 65.0%), intensive care unit mortality (RR 1.03; 95%CI 1.00 - 1.07; p = 0.08; I2 = 28.0%), hospital mortality (RR 1.02; 95%CI 0.99 - 1.06; p = 0.13; I2 = 0%), intensive care unit length of stay (mean difference: -0.51 days; 95%CI -1.85 to 0.82; I2 = 63.0%), and hospital length of stay (mean difference: 0.80 days; 95%CI -1.72 to 3.32; I2 = 47.0%). High-flow nasal cannula showed a non-significant trend toward lower post-extubation respiratory failure and intensive care unit mortality in patients ventilated > 5 days.
conclusionIn adult patients at high risk of extubation failure, the use of high-flow nasal cannula is not associated with significant differences in reintubation rates, intensive care unit or hospital mortality, or intensive care unit or hospital length of stay compared with noninvasive ventilation.PROSPERO register: CRD420251104362.
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