This systematic review pooled 11 randomized trials involving 2473 adults recovering from cardiac surgery, comparing high-flow nasal cannula with conventional oxygen therapy. High-flow therapy reduced escalation of respiratory support (RR 0.71; 95% CI 0.55–0.93). However, delirium was more frequent with high-flow therapy (RR 3.63; 95% CI 1.80–7.30). Oxygenation and forced expiratory volume in 1 second improved, but there were no statistically significant differences in intubation, overall mortality, hospital or intensive care unit length of stay, or postoperative atrial fibrillation.
High-flow oxygen after cardiac surgery may reduce escalation of respiratory support, but the reported delirium signal warrants attention. The pooled findings do not establish a mortality or intubation benefit.
Study limitation: The abstract provides no absolute event rates or outcome-specific trial counts, limiting assessment of benefit magnitude and the delirium signal.
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