Relevant studies for nasal high flow (NHF) use in immunocompromised patients with acute respiratory failure (ARF)
| Design | Patients | Results | |
| Benefit | |||
| Coudroy et al. [69] | Retrospective observational study | 115 immunocompromised patients with ARF treated with NIV or NHF | The NHF group had significantly lower rates of intubation and mortality in the ICU and at day 28 than the NIV group |
| Frat et al. [70] | Post hoc analysis | 82 immunocompromised patients with ARF treated with NIV, NHF or SOT | The NHF group had significantly lower rates of intubation and mortality than the NIV group. No significant difference in intubation and mortality rates was noted between SOT and NHF |
| Mokart et al. [71] | Retrospective propensity-score analysis | 178 cancer patients with severe ARF received oxygen through SOT, NHF or through the combinations NHF–NIV or SOT–NIV | Compared to the other patients, patients who received NHF–NIV combination presented a lower day-28 mortality rate, a longer time from ICU admission to intubation and a higher, but not significant number of ventilator-free days. NHF–NIV was independently associated with improved survival |
| Epstein et al. [72] | Retrospective | 183 cancer patients with hypoxia treated with NHF | 41% improved while on the device, 44% remained stable and 15% declined. The device was well tolerated with few complaints |
| Lee et al. [73] | Retrospective | 45 patients with haematological malignancies who developed ARF | 20% of the patients showed a good response to NHF therapy while the remaining 80% of patients failed to respond to the initial NHF therapy requiring intubation with mechanical ventilation, NIV or narcotic palliation alone |
| Roca et al. [74] | Retrospective | 37 lung transplant recipients with ARF who received NHF or SOT | Absolute risk reduction for mechanical ventilation with NHF therapy was 29.8% and the NNT to prevent one intubation with NHF was 3. NHF therapy was associated with a decreased risk of mechanical ventilation |
| No benefit | |||
| Lemiale et al. [75] | Prospective, multicentre, parallel-group RCT | 100 immunocompromised patients with ARF, randomised to NHF or SOT | No significant difference regarding the need for invasive ventilation/NIV during the 2-h study period. Additionally, no significant difference reported regarding dyspnoea score, respiratory rate and heart rate |
| Harada et al. [76] | Retrospective | 56 patients with haematological malignancies with ARF under NHF treatment | 20% responded well to NHF therapy, while 80% failed, and they underwent a second-line therapy with invasive mechanical ventilation, NIV or narcotic palliation |
NIV: noninvasive ventilation; ICU: intensive care unit; SOT: standard oxygen treatment; NNT: number needed to treat; RCT: randomised controlled trial.