Efeitos do uso de cateter nasal de alto fluxo na intubacao e na reintubacao de pacientes criticos: revisao sistematica, metanalise e analise de sequencia de ensaios

Translated title of the contribution: The effects of high-flow nasal cannula on intubation and re-intubation in critically ill patients: A systematic review, meta-analysis and trial sequential analysis

Rafael Ladeira Rosa Bocchile, Denise Carnieli Cazati, Karina Tavares Timenetsky, Ary Serpa Neto

Research output: Contribution to journalArticleOtherpeer-review

3 Citations (Scopus)

Abstract

Objective: To evaluate the efficacy of high-flow nasal cannula in the prevention of intubation and re-intubation in critically ill patients compared to conventional oxygen therapy or noninvasive ventilation. Methods: This systematic review was performed through an electronic database search of articles published from 1966 to April 2018. The primary outcome was the need for intubation or re-intubation. The secondary outcomes were therapy escalation, mortality at the longest follow-up, hospital mortality and the need for noninvasive ventilation. Results: Seventeen studies involving 3,978 patients were included. There was no reduction in the need for intubation or re-intubation with high-flow nasal cannula (OR 0.72; 95%CI 0.52 - 1.01; p = 0.056). There was no difference in the need for therapy escalation (OR 0.80, 95% CI 0.59 - 1.08, p = 0.144), mortality at the longest follow-up (OR 0.94; 95%CI 0.70 - 1.25; p = 0.667), hospital mortality (OR 0.84; 95%CI 0.56 - 1.26; p = 0.391) or noninvasive ventilation (OR 0.64, 95%CI 0.39 - 1.05, p = 0.075). In the trial sequential analysis, the number of events included was lower than the optimal information size with a global type I error > 0.05. Conclusion: In the present study and setting, high-flow nasal cannula was not associated with a reduction of the need for intubation or re-intubation in critically ill patients.

Translated title of the contributionThe effects of high-flow nasal cannula on intubation and re-intubation in critically ill patients: A systematic review, meta-analysis and trial sequential analysis
Original languagePortuguese
Pages (from-to)487-495
Number of pages9
JournalRevista Brasileira de Terapia Intensiva
Volume30
Issue number4
DOIs
Publication statusPublished - Oct 2018
Externally publishedYes

Keywords

  • Catheters
  • Intubation, intratracheal
  • Noninvasive ventilation
  • Oxygen inhalation therapy

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