{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T04:30:10Z","timestamp":1764995410505,"version":"3.46.0"},"reference-count":21,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T00:00:00Z","timestamp":1649635200000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007834","name":"Natural Science Foundation of Ningbo","doi-asserted-by":"publisher","award":["2019A610276"],"award-info":[{"award-number":["2019A610276"]}],"id":[{"id":"10.13039\/100007834","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,3,27]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>When COVID-19 patients develop hypoxaemic respiratory failure, they often undergo early intubation. Such a potentially aerosol-generating approach places caregivers at increased risk of contracting COVID-19. This protocol aims to evaluate the clinical efficacy and safety of a high-flow nasal cannula (HFNC) for the treatment of COVID-19 patients with acute hypoxaemic respiratory failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We intend to search MEDLINE, Embase, Web of Science and Cochrane Library to identify all randomised controlled trials (RCTs) on the use of HFNC in COVID-19 patients with acute respiratory failure. We will screen the RCTs against eligibility criteria for inclusion in our review. Two reviewers will independently undertake RCT selection, data extraction and risk of bias assessment. Primary outcome will be the rate of intubation, and secondary outcomes will be intensive care unit (ICU)\/hospital mortality, ICU\/hospital length of stay and risks of infection transmission. We will conduct meta-analyses to determine the risk ratio for dichotomous data and the mean difference (MD) or standardised MD for continuous data. Subgroup analyses will be performed based on the different quality of studies, different levels of disease severity, and the age and sex of participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval is not required for this study considering this is a systematic review protocol that uses only published data. The findings of this study will be disseminated through peer-reviewed publications and conference presentations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42021236519.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-057743","type":"journal-article","created":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T13:05:46Z","timestamp":1649768746000},"page":"e057743","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical efficacy and safety of high-flow nasal cannula (HFNC) in acute hypoxaemic patients with COVID-19: a protocol for a systematic review and meta-analysis"],"prefix":"10.1136","volume":"12","author":[{"given":"Lei","family":"Yang","sequence":"first","affiliation":[{"name":"ICU, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weili","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Zhenhai Hospital of Traditional Chinese Medicine, Ningbo, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gongjie","family":"Ye","sequence":"additional","affiliation":[{"name":"ICU, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8634-4052","authenticated-orcid":false,"given":"Zhouzhou","family":"Dong","sequence":"additional","affiliation":[{"name":"ICU, Li Huili Hospital, Ningbo, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,4,12]]},"reference":[{"key":"2025120519491527000_12.4.e057743.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.07.013"},{"key":"2025120519491527000_12.4.e057743.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-06022-5"},{"key":"2025120519491527000_12.4.e057743.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.2648"},{"key":"2025120519491527000_12.4.e057743.4","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1001\/jama.2020.5394","article-title":"Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy region, Italy","volume":"323","author":"Grasselli","year":"2020","journal-title":"JAMA"},{"key":"2025120519491527000_12.4.e057743.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2004500"},{"key":"2025120519491527000_12.4.e057743.6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0035797"},{"key":"2025120519491527000_12.4.e057743.7","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-2871"},{"key":"2025120519491527000_12.4.e057743.8","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/j.chest.2017.01.004","article-title":"Can High-flow Nasal Cannula Reduce the Rate of Endotracheal Intubation in Adult Patients With Acute Respiratory Failure Compared With Conventional Oxygen Therapy and Noninvasive Positive Pressure Ventilation?: A Systematic Review and Meta-analysis","volume":"151","author":"Ni","year":"2017","journal-title":"Chest"},{"key":"2025120519491527000_12.4.e057743.9","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.rmed.2016.11.004","article-title":"High flow nasal cannula versus conventional oxygen therapy and non-invasive ventilation in adults with acute hypoxemic respiratory failure: a systematic review","volume":"121","author":"Lee","year":"2016","journal-title":"Respir Med"},{"key":"2025120519491527000_12.4.e057743.10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1503326"},{"key":"2025120519491527000_12.4.e057743.11","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1007\/s12630-020-01740-2","article-title":"High-Flow nasal cannula for acute hypoxemic respiratory failure in patients with COVID-19: systematic reviews of effectiveness and its risks of aerosolization, dispersion, and infection transmission","volume":"67","author":"Agarwal","year":"2020","journal-title":"Can J Anaesth"},{"key":"2025120519491527000_12.4.e057743.12","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.08756"},{"key":"2025120519491527000_12.4.e057743.13","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1"},{"key":"2025120519491527000_12.4.e057743.14","first-page":"S29","article-title":"Cochrane methods","volume":"10","author":"Higgins","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2025120519491527000_12.4.e057743.15","unstructured":"Borenstein MHL , Higgins J , Rothstein H . 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