Skip to main content

Table 1 Characteristics of the included studies

From: Effect of oxygenation modalities among patients with postoperative respiratory failure: a pairwise and network meta-analysis of randomized controlled trials

Study (author, year)

Study groups

Study design

Inclusion criteria

Settings of experimental group and control group intervention

Follow-up period

Yu, 2017

HFNC 56, SO 54

Multicenter, prospective, randomize, interventional trial

Patients who underwent thoracoscopic lobectomy because of lung tumor and were at intermediate to high risk for PPC as determined by an ARISCAT score ≥ 26. Patients were immunocompetent, not pregnant, between 18 and 80 years old

HFNC: received at a flow rate if 35 to 60 L/min and FiO2 was titrated from 45 to 100% to maintain a SpO2 of 95% or more

SO: received oxygen via nasal prongs or facemasks with FiO2 titrated between 45 and 100% to maintain SpO2 of 95% or more

72 h following extubation

Futier, 2016

HFNC 108, SO 112

Multicenter, randomized controlled trial

Adult patients scheduled for planned or unplanned abdominal, or abdominal and thoracic surgery with and anticipated duration of 2 h or more and an ARISCAT score ≥ 26

HFNC: flow rate of 50 to 60 L/min to maintain an SpO2 of 95% or more

SO: O2 delivered continuously using nasal prongs or facemasks to maintain an SpO2 of 95% or more

7 days post-op

Gupta, 2016

HFNC 10, NIV 10

Pilot study, single-center, randomized controlled trial

Postoperative hypoxemia in post-liver transplant patients

HFNC: initiated at a flow rate of 60 L/min and titrated according to ABG

NIV: set EPAP of 5 cm and IPAP at 10 cm and titrated according to ABG

48 h post-op.

Jaber, 2016

SO 145, NIV 148

Multicenter, randomized, parallel-group clinical trial

Patients older than 19 who had undergone laparoscopic or non-laparoscopic elective or nonelective abdominal surgery under general anesthesia that were diagnosed with ARF within 7 days of surgical procedure defined as persistence of more than 30 min of hypoxemia

SO: supplemental O2 at a rate of up to 15 L/min to maintain SpO2 of at least 94%

NIV: facemask connected to an ICU or NIV dedicated ventilator titrating PEEP and FiO2 to maintain an SpO2 of at least 94%

90 days post-op.

Stephan, 2015

HFNC 414, NIV 416

Multicenter, randomized, noninferiority trial

Patients who had undergone cardiothoracic surgery who developed ARF (failure of SBT or successful SBT but failed extubation) or were deemed at risk for respiratory failure post-extubation due to preexisting risk factors

HFNC: initial rate of 50 L/min with initial FiO2 50% adjusted to maintain SpO2 92% or more

BiPAP: full facemask connected to ventilator with adjustments made to PEEP and FiO2 to maintain SpO2 of 92% or more

3 days

Zhu, 2013

NIV 48, SO 47

Single-center, prospective, randomized control study

Patients who after cardiac surgery developed ARF after initial extubation who were hemodynamically stable with no evidence of bleeding

NPPV: BiPAP via facemask. FiO2 adjusted to maintain SpO2 of around 92%

SO: standard medical care and oxygen therapy as needed

Length of hospital stay

Squadrone, 2005

NIV 105, SO 104

Multicenter, randomized, controlled, unblinded study

Post-op elective abdominal surgery under GA if surgery required laparotomy and time of viscera exposure longer than 90 min. Patients were extubated after surgery, and if they developed a PaO2/FiO2 of 300 less, they were included in study.

CPAP: treated with FiO2 of 0.5 plus CPAP of 7.5. After 6 h, patients underwent 1-h screening test breathing O2 through a venture mask at an FiO2 of 0.3. Patients returned to assigned treatment if PaO2/FiO2 ratio was 300 or less, and treatment was interrupted if the ratio was higher than 300

SO: 8 to 10 L/min oxygen.

Length of hospital stay

Auriant, 2001

NIV 24, SO 24

Prospective, randomized controlled trial

Patients with AHRI following lung resection if they met at least three of the following criteria: dyspnea at rest, active contraction of accessory respiratory muscles, PaO2/FiO2 less than 200, chest radiographic abnormalities

NPPV: cushion bridge nasal mask with BiPAP. PS was increased to achieve exhaled TV of 8–10 mL/kg and RR of less than 25 breaths/min. FiO2 was adjusted to obtain SpO2 above 90%

SO: O2 supplementation to achieve SaO2 above 90%

120 days

Antonelli, 2000

NIV 20, SO 20

Single center, prospective, randomized study

Recipients of solid organ transplants with acute hypoxemic respiratory failure. Criteria included acute respiratory distress, respiratory rate greater than 35/min, ratio of PaO2/FiO2 of less than 200, active contraction of accessory muscles or paradoxical abdominal motion

NIV: ventilator connected to full-face mask with titration of PS to obtain exhaled TV of 8 to 10 mL/kg, RR less than 25/min. PEEP increased gradually and up to 10 cm H2O until FiO2 requirement was 0.6 or less. Settings were adjusted based on continuous oximetry and measurements of ABG.

Standard oxygen: Venturi mask started with FiO2 of 40% and titrated to achieve a level of SpO2 90%

NA

  1. HFNC high-flow nasal cannula, SO standard oxygen, NIV non-invasive ventilation, PPC postoperative pulmonary complications, ARISCAT assess respiratory risk in surgical patients in Catalonia, FiO2 fraction of inspired oxygen, SpO2 peripheral capillary oxygen saturation, L liters, min minute, ABG arterial blood gas, EPAP expiratory positive airway pressure, IPAP inspiratory positive airway pressure, ARF acute respiratory failure, ICU intensive care unit, PEEP positive end-expiratory pressure, BiPAP bilevel positive airway pressure, SBT spontaneous breathing trail, CPAP continuous positive airway pressure, PaO2 partial pressure of oxygen, AHRI acute hypoxemic respiratory insufficiency, mm millimeter, Hg mercury, TV tidal volume, PS pressure support