Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Respiratory Medicine and Allergology, Kariya Toyota General Hospital, Kariya, Japan.
Nagoya J Med Sci. 2021 Aug;83(3):509-522. doi: 10.18999/nagjms.83.3.509.
High-flow nasal cannula (HFNC) oxygen therapy is used widely for hypoxemic respiratory failure. However, it is unknown whether the use of HFNC is compatible with retaining the ability to eat and drink of patients with end-stage respiratory diseases as a part of palliative care. A retrospective study was conducted on subjects with hypoxic respiratory failure due to end-stage respiratory diseases, including interstitial pneumonia and malignant respiratory diseases, who were treated with HFNC or reservoir mask oxygen therapy and died with do-not-resuscitate (DNR) and do-not-intubate (DNI) status. We compared the duration of eating solids and drinking liquids and clinical variables in the HFNC group with those in the reservoir mask group. The data from a total 43 subjects including 20 with HFNC and 23 with a reservoir mask were analyzed. Fitting HFNC to subjects temporarily improved oxygenation. Durations of survival, eating solids, and drinking liquids in the HFNC group were significantly longer than those in the reservoir mask group. No significant adverse effects were observed in either group. In conclusion, the use of HFNC led to prolonged survival while preserving the ability of oral intake in patients with DNR and DNI status.
高流量鼻导管（HFNC）氧疗广泛用于低氧性呼吸衰竭。然而，HFNC 的使用是否与保留终末期呼吸疾病患者的进食和饮水能力兼容，作为姑息治疗的一部分，目前尚不清楚。对因间质性肺炎和恶性呼吸疾病等终末期呼吸疾病导致低氧性呼吸衰竭且接受 HFNC 或储氧面罩氧疗并伴有不复苏（DNR）和不插管（DNI）状态的死亡患者进行了回顾性研究。我们比较了 HFNC 组和储氧面罩组的固体食物和液体摄入时间以及临床变量。共分析了 43 名患者的数据，其中 20 名接受 HFNC 治疗，23 名接受储氧面罩治疗。暂时为患者配备 HFNC 可改善氧合。HFNC 组的生存时间、固体食物摄入时间和液体摄入时间明显长于储氧面罩组。两组均未观察到明显的不良反应。总之，HFNC 的使用可延长 DNR 和 DNI 状态患者的生存时间，同时保持口服摄入能力。
