经鼻高流量湿化氧疗在缺血性脑卒中患者中应用效果的meta分析OA

Objective To conduct a meta-analysis on the application effect of high-flow oxygen through nasal cannula(HFNC)in patients with ischemic stroke.Methods Randomized controlled trials(RCTs)and quasi trials on the application of HFNC in ischemic stroke patients were retrieved from databases such as CNKI,Wanfang,VIP,PubMed,Web of Science,Embase,and Cochrane Library,with the search period spanning from the inception of each database to December 31,2023.Additionally,reference lists of included studies were manually searched.Two researchers independently conducted literature screening,data extraction,and quality evaluation,using RevMan 5.3 software for data analysis.The combined effect statistic was represented by standardized mean difference(SMD),relative risk(RR),and 95%confidence interval(CI).Results A total of 8 articles and 851 patients were ultimately included in the study.1 A-level literature and 7 B-level literature.The meta-analysis results showed that patients in the HFNC group and the control group had differences in arterial oxygen partial pressure(PaO2)(SMD=1.29,95%CI[0.69,1.89],P<0.0001),arterial oxygen saturation(SaO2)(SMD=0.97,95%CI[0.13,1.81],P=0.02),oxygenation index(SMD=0.62,95%CI[0.41,0.82],P<0.000 01),respiratory rate(SMD=-1.21,95%CI[-1.77,-0.65],P<0.0001),heart rate(SMD=-1.11,95%CI[-1.85,-0.37],P=0.003),tracheal intubation rate(RR=0.49,95%CI[0.35,0.685],P<0.0001)and ICU length of stay(SMD=-2.85,95%CI[-4.50,-1.20],P=0.0007).There was no statistically significant difference in arterial partial pressure of carbon dioxide(PaCO2)(SMD=-0.60,95%CI[-1.29,0.08],P=0.08),and mortality rate(RR=0.97,95%CI[0.50,1.85],P=0.92).Conclusion HFNC can increase patients'PaO2 and SaO2,improve oxygenation index,stabilize respiratory rate and heart rate,shorten ICU stay,and reduce tracheal intubation.However,the quality of the included studies is moderate,and more high-quality,multicenter RCTs are still needed for validation in the future.