High flow nasal cannula for patients undergoing bronchoscopy and gastrointestinal endoscopy: A systematic review and meta-analysis

作者：Yuan Tao, Mingyang Sun, Mengrong Miao, Yaqian Han, Yi Yang, Xuhui Cong, Jiaqiang Zhang · 发表于：Frontiers in Surgery · 年份：2022 · DOI：10.3389/fsurg.2022.949614 · 被引用次数：31 · 研究领域：Airway Management and Intubation Techniques、Tracheal and airway disorders、Respiratory Support and Mechanisms

Background High flow nasal cannula is gaining increasingly used in patients undergoing endoscopic procedures. We undertook this systematic review and meta-analysis to determine whether high flow nasal cannula (HFNC) could effectively minimize the risk of hypoxemia as compared with conventional oxygen therapy (COT). Methods We performed a comprehensive search of Pubmed, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and Web of Science. Studies involving the application of HFNC during endoscopic procedures were identified. Results We included 15 randomized controlled trials (7 bronchoscopy, 8 gastrointestinal endoscopy). Patients receiving HFNC during endoscopic procedures had a significantly lower risk of hypoxemia (defined as SpO 2 < 90%) versus COT group (risk ratio = 0.32; 95%CI (0.22–0.47), 13 studies, 4,093 patients, moderate-quality evidence, I 2 = 48.82%, P < 0.001). The lowest SpO 2 was significantly higher in HFNC group (mean difference = 4.41; 95%CI (2.95–5.86), 9 studies, 1,449 patients, moderate-quality evidence, I 2 = 81.17%, P < 0.001) than those receiving COT. No significant difference was detected between groups in end-procedure partial pressure of CO 2 (standard mean difference = −0.18; 95%CI (−0.52–0.15), 5 studies, 238 patients, moderate-quality evidence, I 2 = 42.25%, P = 0.29). Patients receiving HFNC were associated a lower need for airway intervention (risk ratio = 0.45; 95%CI (0.24–0.84), 8 studies, 2,872 patients...