We assessed 87 full-text articles or abstracts for their eligibility, followed by the exclusion of 78 articles because of study aim/design (n = 27), population (n = 37), intervention (n = 10), and measurement (n = 4). After 199 duplicates were removed, 359 articles were screened, and 272 were excluded. The search was performed according to the PICO (Patient Problem or Population, Intervention, Comparison or Control, and Characteristics of Included Studiesįigure 1 illustrates the study selection process. 35 We searched the PubMed, Embase, Cochrane Library, Chinese Sino-Med, China National Knowledge Infrastructure, and Chinese WanFang Med Online databases to identify potentially eligible studies published from their inception to November 2021. This meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Section snippets Literature Search and Data Abstraction We analyzed the results of 9 studies, and the effect of HFNC on patients with AHF was compared with conventional oxygen therapy to provide evidence for clinical practice to NPs practicing in acute care settings. Initiating HFNC in a timely manner can improve patient outcomes. Nurse practitioners (NPs) care for patients who are hospitalized for AHF. 33 Consequently, HFNC can be associated with a hemodynamic improvement in AHF patients. Also, in patients with AHF, treatment with HFNC may be associated with a decrease in preload, evaluated by the decrease of the inspiratory collapse of the inferior vena cava. In addition, HFNC can generate a certain degree of positive airway pressure, it may improve ventilation perfusion, balance intrinsic positive end-expiratory pressure (PEEP), 31, 32 help to reduce the respiratory rate and improve oxygen saturation as measured by pulse oximetry (Sp o 2). 30 It can supply heated and humidified gas at a high flow to wash out carbon dioxide in the anatomical dead space, decrease the entrainment of ambient air, reduce the work of breathing, and enhance comfort and tolerability in patients.28, 29, 30 28, 29 HFNC is administered via an air or oxygen blender (set for a fraction of inspired oxygen between 21% and 100% at up to 60 L/min flow), active heated humidifier, single heated circuit, and nasal cannula. In recent years, high-flow nasal cannula (HFNC) therapy has attracted widespread attention as an alternative approach to respiratory support for critically ill patients. 24 These devices have significantly reduced the rate of tracheal intubation and mechanical ventilation. Guidelines of the European Society of Cardiology recommend that noninvasive positive-pressure ventilation should be applied as soon as possible in patients with AHF to improve gas exchange and reduce the need for endotracheal intubation (a class II recommendation). Nowadays, conventional oxygen therapy with a nasal cannula or face mask is still the most commonly used modality.25, 26, 27 However, conventional oxygen therapy may be insufficient to meet the oxygen needs of patients with AHF. 23 Therefore, appropriate oxygen therapy should be provided immediately for patients that require it. Moreover, postdischarge 1-year readmission rates of AHF can be >45%, in-hospital mortality ranges from 4% to 10%, and the postdischarge 1-year mortality is up to 25% to 30%.16, 17, 18, 19, 20, 21, 22 For these patients, dyspnea, orthopnea, respiratory failure, tachypnea (>25 breaths/min), and increased work of breathing are common. Approximately 50% of HF-related hospitalizations are classified as AHF.

14, 15Īcute HF (AHF) refers to the rapid or gradual onset of symptoms and/or signs of HF and is a leading cause of hospitalizations for patients aged >65 years. 13 Owing to population growth, aging, and the increasing prevalence of comorbidities, the number of hospitalizations for HF is expected to increase by as much as 50% in the next 25 years. 2 The prevalence of HF is ∼1% to 2% of adults in Europe,3, 4, 5, 6, 7, 8 increasing with age from ∼1% for those aged 10% for those aged ≥70 years.9, 10, 11, 12 In China, 1.3% of people aged ≥35 years, or an estimated 13.7 million individuals, have HF. 1, 2 The number of patients hospitalized for HF increased by 26% from 2013 to 2017 in the United States. Heart failure (HF) is a common health condition worldwide and is defined as a complex clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood, concomitant with high morbidity and mortality.

High flow nasal cannula