Respiratory failure & ventilation
High-flow nasal oxygen versus conventional oxygen therapy and noninvasive ventilation in COVID-19 respiratory failure: a systematic review and network meta-analysis of randomised controlled trials
Authors' conclusion
Noninvasive ventilation, high-flow nasal oxygen, and conventional oxygen therapy are comparable with regards to treatment failure and mortality in COVID-19-associated acute respiratory failure.
Study context
- Population
- Patients with COVID-19 acute respiratory failure
- Participants
- 2,302 patients · 8 RCTs
- Comparison
- Noninvasive ventilation (NIV) and high-flow nasal oxygen (HFNO) vs COT
- COTn = 756reference
- NIVn = 371
- HFNOn = 1,175
- Outcome
- Treatment failure (discontinuation of HFNO, NIV, or COT despite progressive disease)
Methodological detailsfrequentist network meta-analysis, random-effects meta-analysis, PubMed, Embase, and the Cochrane library searched in May 2023
- Frequentist network meta-analysis
- Random-effects meta-analysis
- PubMed, Embase, and the Cochrane library searched in May 2023
Pooled result
As reported in the abstract
Treatment failure
- NIV vs COT: P = 0.33
- HFNO vs COT: P = 0.25
Further pooled results
| Outcome | OR (CI) | |
|---|---|---|
| MortalityNIV vs COT | 1.06 (0.46–2.44) | |
| MortalityHFNO vs COT | 0.97 (0.57–1.65) | |
| 0.512Odds ratio (log scale) |
Mortality
- Odds of mortality similar for all three treatments
Original publication
High-flow nasal oxygen versus conventional oxygen therapy and noninvasive ventilation in COVID-19 respiratory failure: a systematic review and network meta-analysis of randomised controlled trials. Br J Anaesth. Published 2 February 2024. doi:10.
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