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高血压性肺水肿患者中高流量氧疗与标准氧疗的比较。

Comparison of high-flow oxygen treatment and standard oxygen treatment in patients with hypertensive pulmonary edema.

机构信息

Department of Emergency Medicine, Adana City Training and Research Hospital; Adana-Turkey.

出版信息

Anatol J Cardiol. 2020 Oct;24(4):260-266. doi: 10.14744/AnatolJCardiol.2020.50680.

Abstract

OBJECTIVE

The aim compares the blood gases, vital signs, mechanical ventilation requirement, and length of hospitalization in patients with hypertensive pulmonary edema treated with standard oxygen therapy (SOT) and high-flow oxygen therapy (HFOT).

METHODS

This prospective observational study was conducted in patients with tachypneic, hypoxemic, hypertensive pulmonary edema. The patients' 0th, 1st, and 2nd hour blood gas results; 0th, 1st, and 2nd hour vital signs; requirement of endotracheal intubation, length of hospitalization, and the prognosis were recorded on the study form.

RESULTS

A total of 112 patients were included in this study, of whom 50 underwent SOT and 62 received HFOT. The initial blood gas analysis revealed significantly lower levels of pH, PaO2, and SpO2 and significantly higher levels of PaCO2 in the HFOT group. Patients in the HFOT group had significantly higher respiratory rate and pulse rate and significantly lower SpO2 values. The recovery of vital signs was significantly better in the HFOT group (p<0.05). Similarly, follow-up results of arterial blood gas analysis were better in the HFOT group (p<0.05). Both length of stay in the emergency department (p<0.05) and length of intensive care unit hospitalization s significantly shorter in the HFOT group (p<0.05).

CONCLUSION

HFOT can be much more effective in patients with hypertensive pulmonary edema than SOT as it shortens the length of stay both in the emergency service and in the intensive care unit. HFOT also provides better results in terms of blood gas analysis, heart rate, and respiratory rate in the follow-up period.

摘要

目的

比较标准氧疗(SOT)和高流量氧疗(HFOT)治疗高血压性肺水肿患者的血气、生命体征、机械通气需求和住院时间。

方法

本前瞻性观察研究纳入了呼吸急促、低氧血症、高血压性肺水肿患者。记录患者第 0 小时、第 1 小时和第 2 小时的血气结果;第 0 小时、第 1 小时和第 2 小时的生命体征;气管插管的需求、住院时间和预后。

结果

本研究共纳入 112 例患者,其中 50 例接受 SOT,62 例接受 HFOT。HFOT 组初始血气分析显示 pH、PaO2 和 SpO2 显著降低,PaCO2 显著升高。HFOT 组的呼吸频率和脉搏率显著升高,SpO2 值显著降低。HFOT 组生命体征的恢复明显更好(p<0.05)。同样,HFOT 组的动脉血气分析随访结果也更好(p<0.05)。HFOT 组在急诊科(p<0.05)和重症监护病房的住院时间(p<0.05)均明显缩短。

结论

HFOT 治疗高血压性肺水肿的效果优于 SOT,可缩短患者在急诊科和重症监护病房的住院时间。HFOT 还在血气分析、心率和呼吸率的随访结果方面提供了更好的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8667/7585958/5020a8c4351d/AJC-24-260-g001.jpg

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