SynthesisInternational journal of chronic obstructive pulmonary disease2026
Impact of High-Flow Nasal Cannula for Chronic Obstructive Pulmonary Disease Exacerbation: A Systematic Review of Clinical and Physiological Outcomes.
Synthesis in International journal of chronic obstructive pulmonary disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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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Abstract
Background: Chronic obstructive pulmonary disease (COPD) caused 3.72 million deaths in 2021. Exacerbations drive morbidity and hospital admissions. Conventional oxygen therapy (COT) offers limited support, while non-invasive ventilation (NIV) improves outcomes but is often poorly tolerated. High-flow nasal cannula (HFNC) delivers heated, humidified oxygen at high flow rates, improving gas exchange and comfort. This systematic review (PRISMA-guided) examines HFNC use in acute and chronic hypercapnic COPD compared with COT and NIV. Methods: Systematic searches of MEDLINE, Embase and CENTRAL (to 2025) identified 14 primary studies (7 randomized trials, 7 observational cohorts). Physiological, clinical and patient-reported outcomes were extracted. Risk of bias was evaluated using RoB 2 and ROBINS-I. Results: In acute settings, HFNC consistently improved PaCO Conclusion: HFNC provides physiological benefits and lowers short-term failure versus COT and reduces home exacerbations. However, it is less effective than NIV for severe hypercapnic failure. HFNC should be reserved for mild-to-moderate exacerbations or NIV-intolerant patients, with close monitoring and predefined escalation criteria.
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