Evidence map›Paper›PMID 42387305›Full record

SynthesisThe clinical respiratory journal2026

High-Flow Nasal Cannula in Hypercapnic Respiratory Failure: An Updated Systematic Review and Meta-Analysis.

Yongkang Huang, Na Li, Yajuan Qian, Mengyuan Shao, Shiyuan Gao, Zengli Zhang

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The clinical respiratory journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

6 authors.

Yongkang HuangDepartment of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.ORCID https://orcid.org/0000-0002-4811-001X
Na LiDepartment of Medicine, Respiratory, Emergency and Intensive Care Medicine, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Yajuan QianDepartment of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Mengyuan ShaoDepartment of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Shiyuan GaoDepartment of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Zengli ZhangDepartment of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.ORCID https://orcid.org/0009-0003-3313-3555

Funding

Suzhou Applied Basic Research (Medical and Health) Science and Technology Innovation Project SYWD2024028Suzhou Science and Education Strengthening Health Project ZDXM2024005
6 · The paper itself

Abstract

backgroundHigh-flow nasal cannula (HFNC) and bi-level positive airway pressure (BiPAP) are both employed in the management of acute hypercapnic respiratory failure, yet their comparative benefits remain uncertain. We conducted an updated systematic review and meta-analysis of randomized controlled trials (RCTs) to compare efficacy, safety, and tolerability of HFNC versus BiPAP in adults with hypercapnic respiratory failure.

methodsWe searched PubMed, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), CNKI, and Wanfang Data through June 2025 for RCTs enrolling patients aged ≥ 16 years with arterial carbon dioxide partial pressure (PaCO

resultsEleven RCTs (n = 1069) met inclusion criteria. Intubation (risk difference [RD] = -0.02, 95% CI -0.06 to 0.03) and mortality rates (RD = -0.02, 95% CI -0.06 to 0.02) were similar between modalities. HFNC and BiPAP showed no significant difference in PaCO

conclusionHFNC and BiPAP offer comparable clinical outcomes in acute hypercapnic respiratory failure. BiPAP offers modest physiological advantages, whereas HFNC provides better patient comfort and less adverse events. Large-scale, multicenter RCTs are needed to further delineate the comparative benefits of HFNC versus BiPAP in diverse patient groups.

Indexed as

CannulaHypercapniaOxygen Inhalation TherapyRespiratory InsufficiencyHumansIntensive Care UnitsOxygenRandomized Controlled Trials as TopicTreatment OutcomeOxygenbi‐level positive airway pressurehigh‐flow nasal cannulahypercapniarespiratory failure

Identifiers

PMID42387305
PMCPMC13323174

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.