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 comprise the 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 1,012 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 three eligible comparative studies showed an overall insignificant effect with higher oxygen saturation among HFNC patients (SMD =  −0.083, 95% CI −0.768 to 0.602, and 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 to 0.534, and 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 HFNC and control groups. It is noteworthy to mention that no complications were reported in our analysis, which implies the safety of HFNC in patients with asthmatic exacerbations.

Keywords: Bronchial asthma, asthmatic exacerbation, high-flow nasal cannula, systematic review, meta-analysis.