Introduction: Postoperative pulmonary complications (PPCs) are substantial causes of perioperative morbidity and mortality leading to prolonged hospital stay and higher costs. The benefits of High Flow Nasal Oxygen (HFNO) as a postoperative respiratory support strategy have been increasingly investigated but findings are still not well-established.  

Objective: To evaluate the efficacy and safety of High Flow Nasal Oxygen (HFNO) compared to conventional oxygen therapy (COT) on postoperative pulmonary complications and clinical outcomes among postextubation adult surgical patients

Methods: This was a systematic review and meta-analysis of published literature regarding adult surgical patients receiving HFNO vs COT that reported escalation of respiratory support, other postoperative complications and clinical outcomes.  

Results: We identified 13 RCTs (n = 1354) included for analysis. HFNO significantly decreased the rate of escalation of respiratory support among postextubation adult surgical patients compared to COT. There were no differences in the incidence of pneumonia, postoperative atelectasis, oxygen therapy after treatment, ICU admission, mortality and length of hospital stay.Conclusion: HFNO was associated with a significant decrease in rate of escalation of respiratory support compared to COT among postextubation adult surgical patients but there were no sufficient evidence in the reduction of pneumonia, postoperative atelectasis, oxygen therapy after treatment, ICU admission, mortality and length of hospital stay.