High-flow nasal cannula oxygen (HNFC) may be a relatively new therapy utilized in adults with respiratory failure. Whether it’s superior to traditional oxygen therapy (COT) or to noninvasive mechanical ventilation (NIV) remains unclear. The aim of the current study was to research whether HFNC was superior to either COT or NIV in adult acute respiratory failure patients.

Methods
A review of the literature was conducted from the electronic databases from inception up to twenty October 2016. Only randomized clinical trials comparing HNFC with COT or HFNC with NIV were included. The intubation rate was the first outcome; secondary outcomes included the mechanical ventilation rate, the speed of escalation of respiratory support and mortality.