High Flow Nasal Catheter (HFNC) for Sepsis Induced Respiratory Failure After Extubation Meta Analysis of Clinical Control Studies on Reintubation Rate and Mortality

  • Bo Li Shaanxi Traditional Chinese Medicine Hospital
  • Xuanguo Zhang Shaanxi Traditional Chinese Medicine Hospital
  • Gaojie Wang Shaanxi Traditional Chinese Medicine Hospital
  • Qiuzhen Yuan Shaanxi Traditional Chinese Medicine Hospital
  • Minjuan Shi Shaanxi Traditional Chinese Medicine Hospital
  • Li Xi Shaanxi Traditional Chinese Medicine Hospital
Keywords: Sepsis, Respiratory Failure, High Flow Nasal Catheter, Noninvasive Positive Pressure Ventilation


Objective: To analyze the reintubation rate and mortality of patients with sepsis complicated (or induced) respiratory failure after extubation, and to seek evidence-based basis for the efficacy of HFNC in the re intubation rate and mortality of sepsis induced respiratory failure after extubation. Methods: The databases of PubMed, EMBASE, Ovid, CNKI, CBM, VIP and Wanfang were searched to find the clinical studies of patients with sepsis and respiratory failure, and meta-analysis was carried out by Stata software. Results: Meta analysis showed that there was no significant difference between HFNC and noninvasive positive pressure ventilation (NPPV) in 72 hour reintubation rate, mortality during ICU and 28-day in hospital. Conclusion: The reintubation rate and mortality of HFNC after extubation in sepsis induced respiratory failure are equivalent to that of NPPV.


[1] Xie J, Wang H, Kang Y, et al. CHinese Epidemiological Study of Sepsis (CHESS) Study Investigators. The Epidemiology of Sepsis in Chinese ICUs: A National Cross-Sectional Survey. Crit Care Med. 2020 Mar;48(3):e209-e218.

[2] Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016 Feb 23;315(8):801-10.

[3] Genga KR, Russell JA. Update of Sepsis in the Intensive Care Unit. J Innate Immun. 2017;9(5):441-455.

[4] Angus DC, Linde-Zwirble WT, Lidicker J, et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001 Jul;29(7):1303-10.

[5] Xuan LZ, Ma JF, Tao JL. et al. Comparative study of high flow nasal catheter device and noninvasive positive pressure ventilation for sequential treatment in sepsis patients after weaning from mechanical ventilation in intensive care unit[J], Ann Palliat Med, 2021, 10: 6270-6278.

[6] Tongyoo Surat, Tantibundit Porntipa, Daorattanachai Kiattichai et al. High-flow nasal oxygen cannula vs. noninvasive mechanical ventilation to prevent reintubation in sepsis: a randomized controlled trial[J], Ann Intensive Care, 2021, 11: 135.

[7] Nava S, Gregoretti C, Fanfulla F, et al. Noninvasive ventilation to prevent respiratory failure after extubation in high-risk patients. Crit Care Med. 2005 Nov;33(11):2465-70.

[8] Ferrer M, Valencia M, Nicolas JM, et al. Early noninvasive ventilation averts extubation failure in patients at risk: a randomized trial. Am J Respir Crit Care Med. 2006 Jan 15;173(2):164-70.

[9] Demoule A, Chevret S, Carlucci A, et al. oVNI Study Group; REVA Network (Research Network in Mechanical Ventilation). Changing use of noninvasive ventilation in critically ill patients: trends over 15 years in francophone countries. Intensive Care Med. 2016 Jan; 42(1):82-92.

[10] Maggiore SM, Idone FA, Vaschetto R, et al. Nasal high-flow versus Venturi mask oxygen therapy after extubation. Effects on oxygenation, comfort, and clinical outcome. Am J Respir Crit Care Med. 2014 Aug 1;190(3):282-8.

[11] Frat JP, Brugiere B, Ragot S, et al. Sequential application of oxygen therapy via high-flow nasal cannula and noninvasive ventilation in acute respiratory failure: an observational pilot study. Respir Care. 2015 Feb;60(2):170-8.

[12] Frat JP, Thille AW, Mercat A, et al; FLORALI Study Group; REVA Network. High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. N Engl J Med. 2015 Jun 4;372(23): 2185-96.

[13] Hernández G, Vaquero C, Colinas L, et al. Effect of Postextubation High-Flow Nasal Cannula vs Noninvasive Ventilation on Reintubation and Postextubation Respiratory Failure in High-Risk Patients: A Randomized Clinical Trial. JAMA. 2016 Oct 18;316(15):1565-1574.

[14] Hernández G, Vaquero C, González P, et al. Effect of Postextubation High-Flow Nasal Cannula vs Conventional Oxygen Therapy on Reintubation in Low-Risk Patients: A Randomized Clinical Trial. JAMA. 2016 Apr 5;315(13):1354-61.

[15] Xu JQ, Su LX, Yan P, et al. Pulmonary & Critical Care Medicine Group of Chinese Thoracic Society/ Pulmonary & Critical Care Medicine Committee of Chinese Association of Chest Physician. Expert consensus on clinical standardized application of high-flow nasal cannula oxygen therapy in adults. Chin Med J (Engl). 2020 Jun 5;133(11):1322-1324.

[16] Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Crit Care Med. 2021 Nov 1;49(11):e1063-e1143.
Original Research Article