Effect of high-flow nasal cannulae in children with congenital heart disease after extubation postoperatively:a Meta-analysis

ZHU Yuan; DU Chenxi

doi:10.12102/j.issn.2095-8668.2025.11.004

Abstract：Objective:To compare the effect of high-flow nasal cannulae and conventional oxygen therapy in children with congenital heart disease after extubation postoperatively by Meta-analysis.Methods:The clinical controlled trials published in the Cochrane Library,PubMed,EMbase,Web of Science,CBM,CNKI,WanFang Database and VIP about the comparison of high-flow nasal cannulae and conventional oxygen therapy in children with congenital heart disease after extubation postoperatively were searched.The retrieval time was from the inception to June 2023.Meta-analysis was performed by RevMan 5.3 software.Results:A total of 8 articles were included,including 720 pediatric patients.The results of Meta-analysis showed that compared with conventional oxygen therapy,high-flow nasal cannulae could reduce the re-intubation rate(RR=0.30,95%CI 0.19-0.47,P<0.000 01),and the incidence of atelectasis(RR=0.57,95%CI 0.37-0.87,P=0.01),and shorten the length of ICU hospitalization(MD=-1.42,95%CI-2.77--0.06,P=0.04).High-flow nasal cannulae could improve PaO2 at 6,12,24,48 h after extubation(P<0.05,respectively),reduce PaCO2 at 1,6,12 h after extubation(P<0.05,respectively),and improve PaO2/FiO2 at 1,6,12,24,48 h after extubation(P<0.000 01).There is no statistically significant difference in the impact of PaO2 at 1 h and PaCO2 at 24,48 h after extubation(P>0.05,respectively).Conclusion:Existing evidence suggests that high-flow nasal cannulae can reduce the rate of re-intubation and atelectasis in pediatric patients with congenital heart disease after extubation postoperatively,and shorten the ICU hospitalization time,improve PaO2 and PaO2/FiO2,reduce PaCO2 compared to conventional oxygen therapy.