High-flow nasal cannula in adults with chronic respiratory diseases during physical exercise: a systematic review and meta-analysis.

IF 3.6 3区 医学 Q1 RESPIRATORY SYSTEM
Eduardo Moya-Gallardo, Jeniffer Fajardo-Gutiérrez, Karol Acevedo, Francisca Verdugo-Paiva, Rocío Bravo-Jeria, Luis Ortiz-Muñoz, Felipe Contreras-Briceño, Maximiliano Espinosa-Ramírez
{"title":"High-flow nasal cannula in adults with chronic respiratory diseases during physical exercise: a systematic review and meta-analysis.","authors":"Eduardo Moya-Gallardo, Jeniffer Fajardo-Gutiérrez, Karol Acevedo, Francisca Verdugo-Paiva, Rocío Bravo-Jeria, Luis Ortiz-Muñoz, Felipe Contreras-Briceño, Maximiliano Espinosa-Ramírez","doi":"10.1136/bmjresp-2024-002431","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Chronic respiratory diseases (CRDs) affect at least 545 million people globally, leading to symptoms such as dyspnoea, fatigue and limited physical activity. Pulmonary rehabilitation (PR) programmes aim to improve the exercise capacity and quality of life of patients with CRD through exercise training. High-flow nasal cannula (HFNC) therapy shows potential as an adjunct treatment during exercise, but its effects on CRD populations are unclear. The purpose of this systematic review was to evaluate the effects of HFNC during exercise in people with CRD.</p><p><strong>Methods: </strong>A systematic review was conducted and eight databases and other resources were searched from inception (28 June 2022) to 4 April 2023. Studies that used adult patients with CRD and randomised controlled trial that compared the effect of HFNC versus standard care (conventional oxygen therapy or room air) during exercise were included. Two authors independently selected trials, extracted the data, assessed risks of bias and employed the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach to judging the certainty of evidence. We pooled trials using random-effect models and inverse variance estimation.</p><p><strong>Results: </strong>Seventeen studies (n=8406) were included in the review (570 patients). The evidence suggests that HFNC increases exercise time after multiple training sessions (weighted mean difference (WMD)=160.58 s; 95% 95% CI=67.32-253.83, 2 studies) and increase after a single session (WMD=72.10 s; 95% CI=28.95-115.24, 11 studies). HFNC may result in little improvements in secondary outcomes (quality of life, dyspnoea, comfort, complications and adherence).</p><p><strong>Discussion: </strong>The evidence suggests that HFNC may increase functional exercise capacity and positively enhance secondary outcomes. Continued research is justified to elucidate the role of HFNC in PR during exercise training.</p><p><strong>Prospero registration number: </strong>CRD42022336263.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499805/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Open Respiratory Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjresp-2024-002431","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Chronic respiratory diseases (CRDs) affect at least 545 million people globally, leading to symptoms such as dyspnoea, fatigue and limited physical activity. Pulmonary rehabilitation (PR) programmes aim to improve the exercise capacity and quality of life of patients with CRD through exercise training. High-flow nasal cannula (HFNC) therapy shows potential as an adjunct treatment during exercise, but its effects on CRD populations are unclear. The purpose of this systematic review was to evaluate the effects of HFNC during exercise in people with CRD.

Methods: A systematic review was conducted and eight databases and other resources were searched from inception (28 June 2022) to 4 April 2023. Studies that used adult patients with CRD and randomised controlled trial that compared the effect of HFNC versus standard care (conventional oxygen therapy or room air) during exercise were included. Two authors independently selected trials, extracted the data, assessed risks of bias and employed the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach to judging the certainty of evidence. We pooled trials using random-effect models and inverse variance estimation.

Results: Seventeen studies (n=8406) were included in the review (570 patients). The evidence suggests that HFNC increases exercise time after multiple training sessions (weighted mean difference (WMD)=160.58 s; 95% 95% CI=67.32-253.83, 2 studies) and increase after a single session (WMD=72.10 s; 95% CI=28.95-115.24, 11 studies). HFNC may result in little improvements in secondary outcomes (quality of life, dyspnoea, comfort, complications and adherence).

Discussion: The evidence suggests that HFNC may increase functional exercise capacity and positively enhance secondary outcomes. Continued research is justified to elucidate the role of HFNC in PR during exercise training.

Prospero registration number: CRD42022336263.

高流量鼻插管在成人慢性呼吸系统疾病患者体育锻炼期间的应用:系统综述和荟萃分析。
背景:全球至少有 5.45 亿人患有慢性呼吸系统疾病 (CRD),导致呼吸困难、疲劳和体力活动受限等症状。肺康复(PR)计划旨在通过运动训练提高慢性呼吸系统疾病患者的运动能力和生活质量。高流量鼻插管(HFNC)疗法作为运动期间的辅助治疗方法具有潜力,但其对 CRD 患者的效果尚不明确。本系统性综述旨在评估高流量鼻导管疗法对慢性阻塞性肺病患者在运动过程中的影响:方法:我们进行了一项系统性回顾,并检索了从开始(2022 年 6 月 28 日)到 2023 年 4 月 4 日的 8 个数据库和其他资源。研究对象包括使用 CRD 成年患者的研究,以及在运动过程中比较 HFNC 与标准护理(常规氧疗或室内空气)效果的随机对照试验。两位作者独立选择试验、提取数据、评估偏倚风险,并采用 GRADE(建议评估、发展和评价分级)方法判断证据的确定性。我们采用随机效应模型和反方差估计法对试验进行了汇总:17项研究(n=8406)被纳入综述(570名患者)。证据表明,HFNC 可增加多次训练后的运动时间(加权平均差 (WMD)=160.58 秒;95% 95% CI=67.32-253.83,2 项研究),增加单次训练后的运动时间(WMD=72.10 秒;95% CI=28.95-115.24,11 项研究)。HFNC 对次要结果(生活质量、呼吸困难、舒适度、并发症和依从性)的改善不大:讨论:证据表明,HFNC 可提高功能锻炼能力,并积极改善次要结果。有理由继续开展研究,以阐明 HFNC 在运动训练期间的 PR 中的作用:CRD42022336263。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
BMJ Open Respiratory Research
BMJ Open Respiratory Research RESPIRATORY SYSTEM-
CiteScore
6.60
自引率
2.40%
发文量
95
审稿时长
12 weeks
期刊介绍: BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信