Objectives: To evaluate the safety and effectiveness of high-flow nasal cannula (HFNC) in patients with asthma exacerbation. Methods: PubMed, Web of Science, Scopus, Science Direct, and Clinical Key were systematically searched in April 2024 to comprisethe relevant data. Comprehensive Meta-Analysis (Version 3.0) was the software used for data analyses. Results: Our results included nine studies with a total of 1012 patients (361 in the HFNC group and 741 in the control group) and 622 (61.5%) were males (179 males in the HFNC group and 443 in the control group). A meta-analysis of 3 eligible comparative studies showed an overall insignificant effect with higher oxygen saturation among HFNC patients (SMD = -0.083, 95% CI -0.768–0.602, p= 0.812). The eight eligible comparative studies showed an overall insignificant longer duration of hospital stay among HFNC patients (SMD = 0.175, 95% CI -0.184–0.534, p= 0.339). There is significant inter-heterogeneity between studies (P<0.05). Conclusion: There is no significant difference in oxygen saturation levels and length of hospital stay among high-flow nasal cannula and control groups. It is noteworthy to mention that no complications were reported in our analysis which implies the safety of high-flow nasal cannula in patients with asthmatic exacerbations.

Keywords: Keywords: Bronchial asthma; Asthmatic exacerbation; High-flow nasal cannula; Systematic review; Meta-analysis.