{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T20:52:29Z","timestamp":1782334349357,"version":"3.54.5"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T00:00:00Z","timestamp":1574208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec><jats:title>BACKGROUND AND OBJECTIVES<\/jats:title><jats:p>High\u2010flow nasal cannula (HFNC) oxygen may provide tailored benefits in patients with preset treatment limitations. The objective of this study was to assess the effectiveness of HFNC oxygen in patients with do\u2010not\u2010intubate (DNI) and\/or do\u2010not\u2010resuscitate (DNR) orders.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>We conducted a systematic review of interventional and observational studies. A search was performed using MEDLINE, EMBASE, CINAHL, Scopus, and Web of Science, from inception to October 15, 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>We included six studies evaluating 293 patients. All studies had a high risk of bias. The hospital mortality rates of patients with DNI and\/or DNR orders receiving HFNC oxygen were variable and ranged from 40% to 87%. In two before and after studies, the initiation of HFNC oxygen was associated with improved oxygenation and reduced respiratory rates. One comparative study found no difference in dyspnea reduction or morphine doses between patients using HFNC oxygen versus conventional oxygen. No studies evaluated quality of life in survivors or quality of death in nonsurvivors. HFNC was generally well tolerated with few adverse events identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>While HFNC oxygen remains a viable treatment option for hospitalized patients who have acute respiratory failure and a DNI and\/or DNR order, there is a paucity of high\u2010quality, comparative, effectiveness data to guide the usage of HFNC oxygen compared with other treatments, such as noninvasive ventilation, conventional oxygen, and palliative opioids.<\/jats:p><\/jats:sec>","DOI":"10.12788\/jhm.3329","type":"journal-article","created":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T11:27:08Z","timestamp":1574249228000},"page":"101-106","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["High\u2010Flow Nasal Cannula Oxygen in Patients with Acute Respiratory Failure and Do\u2010Not\u2010Intubate or Do\u2010Not\u2010Resuscitate Orders: A Systematic Review"],"prefix":"10.1002","volume":"15","author":[{"given":"Michael E","family":"Wilson","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Mayo Clinic Rochester Minnesota"},{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic Rochester Minnesota"},{"name":"Knowledge and Evaluation Research Unit Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aniket","family":"Mittal","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia C","family":"Dobler","sequence":"additional","affiliation":[{"name":"Evidence\u2010Based Practice Center Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Randall","family":"Curtis","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Critical Care, and Sleep Medicine Harborview Medical Center University of Washington Seattle Washington"},{"name":"Cambia Palliative Care Center of Excellence University of Washington Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul M","family":"Majzoub","sequence":"additional","affiliation":[{"name":"Evidence\u2010Based Practice Center Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jalal","family":"Soleimani","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ognjen","family":"Gajic","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia J","family":"Erwin","sequence":"additional","affiliation":[{"name":"Medical Library Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor M","family":"Montori","sequence":"additional","affiliation":[{"name":"Knowledge and Evaluation Research Unit Mayo Clinic Rochester Minnesota"},{"name":"Department of Medicine Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Hassan","family":"Murad","sequence":"additional","affiliation":[{"name":"Robert D. and Patricia E. 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