Review Article

Efficacy of High-Flow Nasal Cannula versus Conventional Oxygen Therapy in Obese Patients during the Perioperative Period: A Systematic Review and Meta-Analysis

Table 1

Basic characteristics of the included clinical trials.

Author, year, locationPopulationClinical settingNumber of patients (H/C)Intervention time pointIntervention detailsControl detailsOutcomes

Corley [12], 2015, AustraliaPatients aged ≥18, with a BMI ≥30Cardiothoracic surgery155 (81/74)PostextubationThe gas flow rate was 35∼50 L/min.The gas flow rate was 2∼4 L/min via nasal cannula or 6 L/min via facemask.
FiO₂: NR.FiO₂: NR.

Sahin [13], 2018, TurkeyPatients with a BMI > 30Coronary artery bypass grafting100 (50/50)PostextubationThe gas flow rate was 25∼40 L/min.The gas flow rate was 2∼4 L/min via facemask.③④
FiO₂ = 50%.FiO₂: NR

.Ferrando [14], 2019, SpainPatients with a BMI ≥ 35Laparoscopic bariatric surgery64 (32/32)PostoperationThe gas flow rate was 60 L/min.The gas flow rate was 15 L/min via facemask.①④
FiO₂ = 50%.FiO₂ = 50%.

Riccio [15], 2019, USAPatients aged 18∼80, with a BMI > 40Elective colonoscopy59 (28/31)5 min before and during the sedation periodThe gas flow rate was 60 L/min.The gas flow rate was 4 L/min via nasal cannula.①②③
FiO₂ = 36∼40%.FiO₂ = 36∼40%.

Wong [17], 2019, CanadaPatients aged ≥ 18, with a BMI ≥ 40Elective surgery45 (23/22)PreoxygenationThe gas flow rate was 40 L/min.The gas flow rate was 15 L/min via facemask.
FiO₂ = 100%FiO₂ = 100%.

Ricottilli [16], 2019, BelgiumObese patients, BMI: (40.6±3.79)Bariatric surgery40 (20/20)Preoxygenation and duration of apneaThe gas flow rate was 50∼70 L/min.The gas flow rate was 12 L/min via facemask.
FiO₂ = 100%.FiO₂ = 100%.

Hamp [19], 2020, AustriaAdult patients with a BMI > 40Bariatric surgery40 (20/20)Apneic oxygenationThe gas flow rate was 120 L/min.The gas flow rate was 10 L/min via nasal cannula.①②
FiO₂ = 100%FiO₂ = 100%.

Fulton [18], 2021, AustraliaPatients aged ≥ 18, with a BMI ≥30Elective bariatric surgery50 (25/25)PostoperationThe gas flow rate was 50 L/min.The gas flow rate was 2 L/min via nasal cannula.①③④
FiO₂ = 50%.FiO₂ = 50%.

Schutzer-Weissmann [22], 2021, UKPatients aged 18∼65 years, with a BMI >40Bariatric surgery80 (41/39)Preoxygenation and duration of apneaThe gas flow rate was 35∼70 L/min.The gas flow rate was 15 L/min via facemask.
FiO₂: NR.FiO₂: NR.

Guy [20], 2021, AustraliaPatients aged ≥ 18, with a BMI ≥35Bariatric surgery45 (22/23)Apneic periodThe gas flow rate was 70 L/min.The gas flow rate was 4 L/min via nasal cannula.
FiO₂ = 100%.FiO₂ = 100%.

Rosén [21], 2022, SwedenPatients aged 18∼60 years, with a BMI >35Laparoscopic bariatric surgery40 (20/20)PostoperationThe gas flow rate was 40 L/min.The gas flow rate was 2 L/min via nasal cannula.
FiO₂ = 30%.FiO₂ = 30%.

Wu [23], 2022, Taiwan, ChinaPatients aged 20∼65, with a BMI>30Laparoscopic sleeve gastrectomy80 (40/40)PreoxygenationThe gas flow rate was 30∼50 L/min.The gas flow rate was 15 L/min via facemask.①②
FiO₂ = 100%FiO₂ = 100%

Outcomes: ① = Hypoxemia; ② = Minimum SpO₂; ③ = Additional respiratory support; ④ = Hospital LOS; FiO₂ = fraction of inspired; SpO₂ = peripheral oxygen saturation; NR = no record.