Fen Liu, Zhenguo Zeng, Chengzhi Ding, and Ning Zhao are physicians, Rong Jiang is matron, and Kejian Qian is director, Department of Critical Care Medicine, First Affiliated Hospital of Nanchang University, Nanchang, China. Yang Liu is docimaster in the Department of Bacteriology, Yong Li is a physician in the Department of Oncology, and Qin Liu is a physician in the Department of Respirology, First Affiliated Hospital of Nanchang University. Qiang Shao is a doctoral candidate at Nanchang University and a physician in the Department of Critical Care Medicine at First Affiliated Hospital of Nanchang University. Zhiyong Peng is director, Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
Am J Crit Care. 2019 Sep;28(5):370-376. doi: 10.4037/ajcc2019130.
High-flow oxygen therapy has been widely adopted, but its use for weaning patients from mechanical ventilation has not been reported.
To evaluate whether high-flow oxygen therapy improves the efficiency of weaning patients from mechanical ventilation.
In a single-center, prospective study, patients receiving mechanical ventilation were randomly assigned to 1 of 3 groups (T-tube, pressure support ventilation, or high-flow oxygen) during 2-hour spontaneous breathing trials in a 14-day study. Participants were followed up until hospital discharge or death.
Of 268 patients included, 90 were assigned to the T-tube group, 96 to the pressure support ventilation group, and 82 to the high-flow oxygen group. The first-day 2-hour spontaneous breathing trial passing rates were higher in the pressure support ventilation and high-flow oxygen groups than in the T-tube group ( < .05). The time needed to pass the spontaneous breathing trial was less in the pressure support ventilation and high-flow oxygen groups than in the T-tube group ( < .05). The reintubation rate was lower and the successful weaning rate on the first day was higher in the high-flow oxygen group than in the T-tube and pressure support ventilation groups ( < .05). During the 14-day study period, the weaning time was less in the high-flow oxygen group than in the T-tube and pressure support ventilation groups ( < .05).
High-flow oxygen therapy can reduce the time needed to wean patients from mechanical ventilation by shortening the time needed to pass a spontaneous breathing trial and by decreasing the reintubation rate.
高流量氧疗已被广泛采用，但尚未有用于机械通气患者脱机的报道。
评估高流量氧疗是否能提高机械通气患者脱机的效率。
在一项单中心前瞻性研究中，在为期 14 天的研究中，在 2 小时自主呼吸试验期间，将接受机械通气的患者随机分配至 T 管组、压力支持通气组或高流量氧疗组。对参与者进行随访，直至出院或死亡。
268 例患者中，90 例分配至 T 管组，96 例分配至压力支持通气组，82 例分配至高流量氧疗组。压力支持通气组和高流量氧疗组第 1 天 2 小时自主呼吸试验通过率高于 T 管组（<0.05）。压力支持通气组和高流量氧疗组通过自主呼吸试验所需的时间短于 T 管组（<0.05）。高流量氧疗组的再插管率低于 T 管组和压力支持通气组，第 1 天的脱机成功率高于 T 管组和压力支持通气组（<0.05）。在 14 天的研究期间，高流量氧疗组的脱机时间短于 T 管组和压力支持通气组（<0.05）。
高流量氧疗通过缩短通过自主呼吸试验所需的时间和降低再插管率，可减少机械通气患者脱机所需的时间。
