To characterize publication growth, identify leading journals and contributors, map collaboration patterns, and reveal the knowledge base, thematic evolution, and emerging hotspots in HFNO research.
Approach:
Data Collection: Conducted a bibliometric analysis using English-language articles and reviews from Web of Science Core Collection, Scopus, and PubMed for the period 2000–2025, resulting in 2,314 unique publications.
Analysis Tools: Utilized Bibliometrix in R for performance analysis, thematic mapping, and thematic evolution; VOSviewer for collaboration analysis; and CiteSpace for co-citation analysis and keyword clustering.
Key Findings:
HFNO research exhibited sustained exponential growth, particularly accelerating after 2018 and 2020.
The literature is primarily concentrated in respiratory medicine, critical care, and anesthesiology journals, with Respiratory Care leading in publication output.
The United States and China are the top contributors, with significant involvement from French institutions.
Co-citation analysis revealed major clusters related to acute respiratory failure, perioperative oxygen therapy, preoxygenation strategies, and coronavirus disease.
Keyword and thematic analyses indicated a shift towards context-specific deployment and monitoring in HFNO applications.
Interpretation:
HFNO research has transitioned from a focus on oxygenation support to a broader application in perioperative and critical care, emphasizing context-specific use and monitoring.
Limitations:
The study focused exclusively on English-language publications, potentially excluding relevant research in other languages.
Neonatal and pediatric populations were excluded, limiting applicability to adult perioperative and critical care.
Conclusion:
Future research should focus on clinically actionable patient stratification, standardized outcome definitions, and protocol-based integration of HFNO across various care pathways.
