Department of Emergency, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China.
Intensive Care Unit, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China.
BMC Pulm Med. 2021 Jan 7;21(1):17. doi: 10.1186/s12890-020-01359-5.
The aim of the present study was to evaluate the therapeutic effect of high-flow nasal cannula (HFNC) oxygen therapy on patients with aspiration pneumonia accompanied by respiratory failure in the post-stroke sequelae stage, with the goal of providing more effective oxygen therapy and improving patient prognosis.
Retrospective analysis was conducted on 103 elderly patients with post-stroke aspiration pneumonia and moderate respiratory failure (oxygenation index: 100-200 mmHg) that had been admitted. The patients were divided into two groups according to the mode of oxygen therapy that was used: the Venturi mask group and the HFNC treatment group. The two groups were analyzed and compared in terms of the changes in the blood gas indices measured at different points in time (4, 8, 12, 24, 48, and 72 h), the proportion of patients that required transition to invasive auxiliary ventilation, and the 28-day mortality rate.
A total of 103 patients were retrospectively analyzed; 16 cases were excluded, and 87 patients were included in the final patient group (42 in the HFNC group and 45 in the Venturi group). There was a statistically significant difference in the oxygenation indices of the HFNC group and the Venturi group (F = 546.811, P < 0.05). There was a statistically significant interaction between the monitored oxygenation indices and the mode of oxygen therapy (F = 70.961, P < 0.05), and there was a statistically significant difference in the oxygenation indices for the two modes of oxygen therapy (F = 256.977, P < 0.05). HFNC therapy contributed to the improvement of the oxygenation indices at a rate of 75.1%. The Venturi and HFNC groups also differed significantly in terms of the proportion of patients that required transition to invasive auxiliary ventilation within 72 h (P < 0.05). The HFNC group's risk for invasive ventilation was 0.406 times that of the Venturi group (P < 0.05). There was no statistical difference in the 28-day mortality rate of the two groups (P > 0.05).
HFNC could significantly improve the oxygenation state of patients with post-stroke aspiration pneumonia and respiratory failure, and it may reduce the incidence of invasive ventilation.
本研究旨在评估高流量鼻导管（HFNC）氧疗对中风后遗症期伴呼吸衰竭的吸入性肺炎患者的治疗效果，以期提供更有效的氧疗并改善患者预后。
回顾性分析 103 例老年中风后吸入性肺炎合并中度呼吸衰竭（氧合指数：100-200mmHg）患者，根据氧疗方式分为文丘里面罩组和 HFNC 治疗组，比较两组患者不同时间点（4、8、12、24、48、72h）血气指标变化、需要转为有创辅助通气的比例及 28 天死亡率。
共纳入 103 例患者，排除 16 例，最终纳入 87 例患者（HFNC 组 42 例，文丘里面罩组 45 例）。HFNC 组与文丘里面罩组氧合指数比较，差异有统计学意义（F=546.811，P<0.05）；监测氧合指数与氧疗方式存在交互作用（F=70.961，P<0.05），两种氧疗方式的氧合指数比较，差异有统计学意义（F=256.977，P<0.05）。HFNC 治疗能使氧合指数改善率达到 75.1%。HFNC 组与文丘里面罩组在 72h 内需要转为有创辅助通气的患者比例比较，差异有统计学意义（P<0.05）。HFNC 组较文丘里面罩组发生有创通气的风险降低 0.406 倍（P<0.05）。两组患者 28 天死亡率比较，差异无统计学意义（P>0.05）。
HFNC 可显著改善中风后吸入性肺炎合并呼吸衰竭患者的氧合状态，可能降低有创通气的发生率。
