Bell Nerida, Hutchinson Claire L, Green Timothy C, Rogan Eileen, Bein Kendall J, Dinh Michael M
Emergency Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Emergency Department, Canterbury Hospital, Sydney, New South Wales, Australia.
Emerg Med Australas. 2015 Dec;27(6):537-541. doi: 10.1111/1742-6723.12490. Epub 2015 Sep 29.
The aim of the study was to determine if oxygen delivered through humidified high flow nasal cannulae (HHFNC) reduced the need for escalation in ventilation management and work of breathing in the ED patients presenting with acute undifferentiated shortness of breath compared with standard oxygen therapy.
This was an unblinded randomised control trial conducted at two hospital EDs in Sydney, Australia. Eligible patients presenting with shortness of breath were randomised to HHFNC or standard oxygen therapy. Primary outcomes were the need to escalate ventilation therapy or a reduction in respiratory rate of 20% or more within 2 h of commencement.
One hundred patients were enrolled in the trial. The intervention group receiving HHFNC was associated with a higher proportion of patients with a reduced respiratory rate at 2 h (66.7% vs 38.5%, P = 0.005) and a lower proportion of patients requiring escalation in ventilation therapy (4.2% vs 19%, P = 0.02) compared with standard oxygen therapy.
The use of high flow nasal cannula oxygenation was associated with improved respiratory state in selected patients presenting to the ED with acute undifferentiated shortness of breath.
本研究旨在确定与标准氧疗相比，通过高流量湿化鼻导管（HHFNC）输送氧气是否能减少急诊科急性未分化性呼吸急促患者通气管理升级的需求以及呼吸功。
这是一项在澳大利亚悉尼的两家医院急诊科进行的非盲随机对照试验。符合条件的呼吸急促患者被随机分配接受HHFNC或标准氧疗。主要结局是在开始治疗后2小时内通气治疗升级的需求或呼吸频率降低20%或更多。
100名患者参与了试验。与标准氧疗相比，接受HHFNC的干预组在2小时时呼吸频率降低的患者比例更高（66.7%对38.5%，P = 0.005），通气治疗需要升级的患者比例更低（4.2%对19%，P = 0.02）。
对于急诊科出现急性未分化性呼吸急促的特定患者，使用高流量鼻导管氧疗与改善呼吸状态相关。
