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Objective:

High-flow nasal cannulae are used in adults with or at risk of acute respiratory failure. We conducted a systematic review and meta-analysis to evaluate the evidence for their use in this setting.

Data Sources:

Ovid Medline, Embase, and Cochrane Database of Systematic Reviews.

Study Selection:

Databases were searched for randomized controlled trials comparing administration of high-flow nasal cannulae with usual care (ie, conventional oxygen therapy or noninvasive ventilation) in adults with respiratory failure. The primary outcome was hospital mortality; the rate of intubation and assessment of delirium and comfort were secondary outcomes.

Data Extraction:

One hundred forty-seven nonduplicate citations were screened, 32 underwent full screening and data extraction, and 14 trials were eligible for inclusion in the review. Nine trials were used in the meta-analysis, including a total of 2,507 subjects …