High-flow nasal cannula for hypoxia in the post-anesthetic recovery unit: A systematic review and meta-analysis

Table 1 Characteristics of included studies

Ref.	Country	N (C/I)	RoB	Surgery	Population	Intervention	Comparator	Primary outcome
Ansari et al[11]	Iran	31/28	SC	Thoracic	All comer	HFNC for 24 hours	NC or FM	6-minute walk at POD2
Brainard et al[16]	United States	26/18	High	Thoracic	Admitted to ICU	HFNC for 48 hours	NC or FM	Composite incidence of reintubation, hypoxemia, NIV
Burra et al[17]	India	30/30	High	Cardiac	All comer	HFNC for 4 hours	NC	pH, PaO2, PaCO2 at 1, 2, 4 hours
Chen et al[4]	China	99/98	Low	Laparoscopic	Age > 65	No description	NC	Incidence of hypoxemia until PACU discharge
Corley et al[12]	Australia	74/81	SC	Cardiac	BMI > 30	HFNC for 8 hours	NC or FM	Atelectasis on POD1
El-Nori et al[13]	Egypt	90/90	SC	Thoracic	All comer	HNFC for 48 hours	NC or FM	Incidence of hypoxemia in hospital
Ferrando et al[5]	Spain	74/81	Low	Bariatric	BMI > 35	HFNC for 3 hours	Venturi	Incidence of hypoxemia at 3 hours
Fogagnolo et al[18]	Italy	58/58	High	Thoracic	ASA 1, 2, BMI < 35	HFNC for 24 hours	NC or FM	Diaphragmatic dysfunction at 24 hours
Frassanito et al[6]	Italy	41/42	Low	Gynecologic	BMI < 35	HFNC for 2 hours	Venturi	PF ratio at 2 hours
Fulton et al[14]	United States	25/25	SC	Bariatric	All comer	HFNC for 6 hours	FM	End expiratory lung impedance at 1 hour
Futier et al[7]	France	112/108	Low	Abdominal, thoracic	At risk for PPC	HFNC until 8AM POD1	NC or FM	Hypoxemia at 1 hour
Li et al[19]	China	30/30	High	Orthopedic	Age > 65	HFNC for 1 hour	FM	pH, PaO2, PaCO2 at 1 hour
Mishra et al[20]	India	30/30	High	Non-thoracic	SaO2 < 90	HFNC for 2 hours	Venturi	PF ratio at 2 hours
Parke et al[21]	New Zealand	171/169	High	Cardiac	All comer	HFNC until 9AM POD2	NC or FM	SpO2/FiO2 > 445 at day 3
Pennisi et al[15]	Italy	48/47	SC	Thoracic	All comer	HFNC until 9AM POD2	Venturi	PF ratio < 300 during first 4 days
Rosén et al[8]	Sweden	15/19	Low	Bariatric	BMI > 35	HFNC for 1 hour	NC	PaO2 at 1 hour
Sahin et al[22]	Turkey	50/50	High	Cardiac	BMI > 30	No description	FM	Not clear
Shiho et al[9]	Japan	35/35	Low	Cardiac	No lung disease	HFNC for 1 hour	Venturi	PaO2 at 1 hour
Soliman et al[23]	Egypt	40/40	High	Abdominal	No lung disease, BMI < 35	HFNC for 6 hours	FM	Incidence of PPC during first 5 days
Sun et al[24]	China	39/39	High	Abdominal	ASA 1, 2, BMI < 30	HFNC while in PACU	NC	Atelectasis
Tatuishi et al[25]	Japan	76/72	High	Cardiac	All comer	HFNC for 18 hours	FM	Lung volume reduction
Theologou et al[26]	United Kingdom	33/66	High	Cardiac	PF ratio < 200 after SBT	HFNC until wean or failure	Venturi	Treatment failure
Vourc'h et al[27]	France	43/47	High	Cardiac	SpO2 < 96% on 50% venturi	HFNC for 48 hours	NRB	PF ratio at 1 and 24 hours
Yu et al[28]	China	54/56	High	Thoracic	At risk for PPC	No description	NC or FM	Incidence of hypoxemia during 72 hours
Zochios et al[10]	United Kingdom	45/49	Low	Cardiac	COPD, Asthma, BMI > 35	HFNC for 24 hours	NC or FM	Hospital LOS

C/I: Number of patients in control/number of interventions; RoB: Risk of bias; SC: Some concerns; HFNC: High flow nasal cannula; NC: Nasal cannula; FM: Face mask; POD: Postoperative day; PF: Arterial oxygen pressure to inspired oxygen fraction; SBT: Spontaneous breathing trial; SpO₂: Peripheral oxygen saturation; BMI: Body mass index; COPD: Chronic obstructive pulmonary disease; PPC: Postoperative pulmonary complication; PACU: Post-anesthesia care unit; NRB: Non-rebreather mask; LOS: Length of stay; ASA: American Society of Anesthesiologists; PaO₂: Partial pressure of arterial oxygen; PaCO₂: Partial pressure of arterial carbon dioxide; ICU: Intensive care unit; POD1: Postoperative day 1.