Abstract: Objective: To systematically assess the clinical efficacy of High Flow Nasal Cannula (HFNC) after extubated in patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD). Methods: The PubMed, Web of science, Cochrane Library, CNKI, Wan Fang, VIP Databases and CBM were retrieved for all published Randomized Controlled Trials (RCT) or cohort studies about HFNC therapy in extubated AECOPD patients. The control group was treated with Noninvasive Positive Pressure Ventilation (NPPV). Results: Ten researches were included, of which six were Chinese and four were English. A total of 869 subjects were included. The results of Meta-analysis showed that HFNC had a significant advantage over NPPV in terms of reducing ICU hospital stay, respiratory rate, and complication rate. There were no significant statistical differences in PaCO2, oxygenation index, mortality and reintubation rate between NPPV and HFNC. Conclusion: Current evidence suggests that HFNC is superior to NPPV in reducing respiratory frequency, ICU hospital stay, and the incidence of complications in patients with AECOPD after extubation. In the future, more high-quality, multi-center RCT studies are needed to further evaluate the effect of HFNC on AECOPD patients after extubation.

Key words: High Flow Nasal Cannula; Acute Exacerbation of Chronic Obstructive Pulmonary Disease; reintubation rate; length of ICU stay; mortality; Meta-analysis