Comparison of High-flow Nasal Cannula (HFNC) and Conventional Oxygen Therapy in Obese Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis
Comparison of High-flow Nasal Cannula (HFNC) and Conventional Oxygen Therapy in Obese Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis
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高流量鼻插管 (HFNC) 与传统氧疗在接受心脏手术的肥胖患者中的比较：系统评价和荟萃分析
作者：
Yanli Wang;Jinkui Zhu;Xiufeng Wang;Na Liu;Qing Yang;Guoan Luan;Xinhui Ma;Juan Liu
背景/目的：高流量鼻插管作为一种新型的术后氧合方式，在术后护理中越来越受到重视。然而，它对接受心脏手术的肥胖患者的重要性仍然存在争议。本系统综述和荟萃分析对该患者组HFNC和常规氧疗（COT）进行了比较和评价。材料与方法：通过8个公共数据库检索文献。选择随机对照试验（RCTs）。采用RevMan 5.3软件对结果及潜在偏倚进行分析。主要结果包括术后24小时肺不张评分。次要结局包括PaO2/FiO2（比率）、术后24 h呼吸困难评分、重症监护病房（ICU）住院时间、再插管情况。结果：在删除重复项后，检索策略产生了382项研究。最后，本研究纳入3项随机对照试验，共526例患者。与COT相比，肺不张评分、呼吸困难评分、再插管和ICU住院时间均无显著差异。结论：对于接受心脏手术的肥胖患者，术后使用HFNC可维持患者氧合。需要进一步的临床研究来调查HFNC在该患者组中的作用。
Background/Aim: High-flow nasal cannula (HFNC), a new method for postoperative oxygenation, has increasingly received attention during postoperative care. However, its importance for obese patients undergoing cardiac surgery remains controversial. This systematic review and meta-analysis compared and evaluated HFNC and conventional oxygen therapy (COT) in this patient group. Materials and Methods: Literature was retrieved by searching eight public databases. Randomized controlled trials (RCTs) were selected. RevMan 5.3 was used to analyze the results and any potential bias. The primary outcome included atelectasis score at 24 h postoperatively. The secondary outcomes included PaO2/FiO2 (ratio), dyspnea score at 24 h postoperatively, intensive care unit (ICU) length of stay, and reintubation. Results: The search strategy yielded 382 studies after duplicates were removed. Finally, 3 RCTs with a total of 526 patients were included in the present study. Compared with COT, there was no significant difference in atelectasis score, dyspnea score, reintubation, and ICU length of stay. Conclusion: For obese patients undergoing cardiac surgery, postoperative use of HFNC can maintain patient’s oxygenation. Additional clinical studies are needed to investigate the role of HFNC in this patient group.