{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T20:28:33Z","timestamp":1783024113908,"version":"3.54.6"},"reference-count":44,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Evidence Based Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate efficacy and safety of high\u2010flow nasal cannula (HFNC) versus noninvasive ventilation (NIV) in adults with hypercapnic respiratory failure (HRF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a meta\u2010analysis of randomized controlled trials from PubMed, Embase, The Cochrane Library, Wanfang, CNKI, and Weipu comparing HFNC with NIV in HRF patients. Primary outcomes were mortality and endotracheal intubation. Secondary outcomes included blood gas values, hospital\/ intensive care unit (ICU) length of stay, nasal skin breakdown, and comfort. Pooled risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI) were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty trials involving 1835 patients were included. No significant differences were observed in mortality (RR, 0.94; 95% CI, 0.69 to 1.28), endotracheal intubation (RR, 0.87; 95% CI, 0.71 to 1.06), PaCO\n                      <jats:sub>2<\/jats:sub>\n                      (MD, \u20130.87\u00a0mmHg; 95% CI, \u20132.98 to 1.25) or PaO\n                      <jats:sub>2<\/jats:sub>\n                      (MD, 2.67\u00a0mmHg; 95% CI, \u20130.66 to 6.01). However, HFNC significantly reduced hospital stay (MD, \u20130.69 days; 95% CI, \u20131.08 to \u20130.30) and ICU stay (MD, \u20130.98 days; 95% CI, \u20131.50 to \u20130.45), lowered nasal skin breakdown risk (RR, 0.20; 95% CI, 0.09 to 0.45) and improved comfort (MD, \u20131.19; 95% CI, \u20131.98 to \u20130.41). Subgroup and sensitivity analyses confirmed the principal findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HFNC was not significantly different from NIV for mortality and endotracheal intubation in HRF but was associated with shorter hospital and ICU stays, reduced nasal facial skin breakdown and improved comfort. Larger trials in diverse populations are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jebm.70139","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T14:56:16Z","timestamp":1782399376000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High\u2010Flow Nasal Cannula Versus Noninvasive Ventilation in the Treatment of Hypercapnic Respiratory Failure: Meta\u2010Analysis of Randomized Controlled Trials"],"prefix":"10.1111","volume":"19","author":[{"given":"Lan","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Precision Medicine Key Laboratory of Sichuan Province West China Hospital of Sichuan University  Chengdu China"},{"name":"Institute of Respiratory Health Frontiers Science Center for Disease\u2010Related Molecular Network West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shijie","family":"Fan","sequence":"additional","affiliation":[{"name":"Center for Evidence\u2010Based Medicine Affiliated Hospital of Chengdu University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuke","family":"Cheng","sequence":"additional","affiliation":[{"name":"West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bojiang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Precision Medicine Key Laboratory of Sichuan Province West China Hospital of Sichuan University  Chengdu China"},{"name":"Institute of Respiratory Health Frontiers Science Center for Disease\u2010Related Molecular Network West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Precision Medicine Key Laboratory of Sichuan Province West China Hospital of Sichuan University  Chengdu China"},{"name":"Institute of Respiratory Health Frontiers Science Center for Disease\u2010Related Molecular Network West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center for Evidence\u2010Based Medicine Affiliated Hospital of Chengdu University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weimin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Precision Medicine Key Laboratory of Sichuan Province West China Hospital of Sichuan University  Chengdu China"},{"name":"Institute of Respiratory Health Frontiers Science Center for Disease\u2010Related Molecular Network West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-069679"},{"issue":"1","key":"e_1_2_7_3_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjresp-2023-002266","article-title":"Long\u2010Term Cohort Study of Patients Presenting with Hypercapnic Respiratory Failure","volume":"11","author":"Chung Y.","year":"2024","journal-title":"BMJ Open Respiratory Research: Homepage"},{"issue":"7","key":"e_1_2_7_4_1","article-title":"Non\u2010Invasive Ventilation for the Management of Acute Hypercapnic Respiratory Failure due to Exacerbation of Chronic Obstructive Pulmonary Disease","volume":"7","author":"Osadnik C. 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