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高流量鼻导管:一种有前途的氧疗方法,适用于伴有呼吸衰竭的严重支气管哮喘患者。

High-Flow Nasal Cannula: A Promising Oxygen Therapy for Patients with Severe Bronchial Asthma Complicated with Respiratory Failure.

机构信息

Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100000, China.

Department of Respiratory Medicine, The Hospital Affiliated to the Inner Mongolia University for Nationalities, Tongliao 028000, China.

出版信息

Can Respir J. 2020 Feb 20;2020:2301712. doi: 10.1155/2020/2301712. eCollection 2020.

Abstract

Severe bronchial asthma complicated with respiratory failure, a common critical illness in respiratory medicine, may be life-threatening. High-flow nasal cannula (HFNC) is a novel oxygen therapy technique developed in recent years. HFNC was applied in this study for treating adult patients with severe bronchial asthma complicated with respiratory failure. Its efficacy was analyzed comparatively to conventional oxygen therapy (COT). HFNC and COT were randomly performed based on conventional treatment. The HFNC group was similar to COT-treated patients in terms of response rate, with no significant difference in efficacy between the two groups. In patients with bronchial asthma, effectively increased PO and reduced PCO were observed after treatment in both groups. However, HFNC was more efficient than COT in elevating PO in patients with severe bronchial asthma complicated with respiratory failure, while no statistically significant difference in PCO reduction was found between the two groups. Heart rate (HR) and respiratory rate (RR) between the two groups on admission (0 h) and at 2, 8, 24, and 48 h after admission were compared. Both indicators significantly decreased with time. No significant differences in HR and RR were found between the groups at 0, 2, and 8 h after admission. However, these indicators were significantly lower in the HFNC group compared with the COT group at 24 and 48 h after admission. HFNC could significantly elevate PO and reduce HR and RR. Thus, it is a promising option for patients with severe bronchial asthma complicated with respiratory failure.

摘要

严重支气管哮喘并呼吸衰竭,是呼吸科常见的危急重症,可能危及生命。高流量鼻导管(HFNC)是近年来发展起来的一种新型氧疗技术。本研究应用 HFNC 治疗成人严重支气管哮喘并呼吸衰竭患者,与常规氧疗(COT)进行疗效比较。HFNC 和 COT 均在常规治疗基础上随机进行。HFNC 组与 COT 组的反应率相似,两组疗效无显著差异。两组患者支气管哮喘均有效升高 PO ,降低 PCO。但 HFNC 组在升高严重支气管哮喘并呼吸衰竭患者 PO 方面较 COT 更有效,两组 PCO 降低无统计学差异。比较两组入院时(0 小时)及入院后 2、8、24、48 小时的心率(HR)和呼吸频率(RR)。各指标均随时间逐渐降低。入院后 0、2、8 小时两组 HR 和 RR 无统计学差异,但入院后 24、48 小时 HFNC 组明显低于 COT 组。HFNC 能显著升高 PO ,降低 HR 和 RR。因此,HFNC 是严重支气管哮喘并呼吸衰竭患者有前途的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02e8/7054795/a962a65e511a/CRJ2020-2301712.001.jpg

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