High-Flow Nasal Cannula in Hypercapnic Respiratory Failure: A Systematic Review and Meta-Analysis
Table 1
Characteristics of cohort studies.
Authors, year
Participates of the cohort (HFNC/NIV)
Case source
Cause of hypercapnic respiratory failure
Follow-up (days)
Location
Major inclusive criteria
Initial indications of HFNC
Initial indications of NIV
Primary outcome
NOS scores
Sun et al., 2019
39/43
ICU
AECOPD or pulmonary infection with COPD
28
China
COPD or acute respiratory failure by a secondary diagnosis of COPD with a respiratory acidosis (pH ≤ 7.35 and PaCO2 ≥ 50 mmHg)
Initial FiO2 in the HFNC group was 0.3 (0.2–0.4), and the gas flow rate was 50 L/min (40–50).
Initial FiO2 in the NIV group was 0.4 (0.3–0.6), inspiratory airway pressure was 10 cm H2O (8–12), and expiratory airway pressure was 4 cm H2O (4-5). Mean expiratory tidal volume during the first 24 hrs of NIV treatment was 5.4 ± 2.4 ml/kg of predicted body weight.
Treatment failure and 28-day mortality
5
Lee et al., 2018
44/44
Respiratory ward
AECOPD
30
South Korea
AECOPD with moderate hypercapnic acute respiratory failure ((PaO2)/FiO2 < 200 mmHg, PaCO2 > 45 mmHg, and 7.25 < pH < 7.35 on room air)
Beginning with FiO2 > 50% and a flow of 35 L/min and then titrating flow to 45–60 L/min if tolerated. FiO2 was subsequently adjusted to maintain an oxygen saturation of 92% or more.
The expiratory pressure was set at 5 cm H2O pressure, and inspiratory pressure was initially set at 10 cm H2O and then increased in increments of 2–4 to 20 cm H2O or the maximum tolerated over 1 hour. The BiPAP level was adjusted to maintain an oxygen saturation of 92% or more.
