Chen Xiaoqi, Tan Caiping, Jiang Huojun
Intensive Care Unit, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine Suzhou 215101, Jiangsu, P. R. China.
Department of Emergency, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine Suzhou 215101, Jiangsu, P. R. China.
Am J Transl Res. 2023 Feb 15;15(2):1239-1246. eCollection 2023.
Optimal oxygen supply is the cornerstone of the management of critically ill patients after extubation. High flow oxygen system is an alternative to standard oxygen therapy. This research explored the efficacy of high-flow nasal cannula (HFNC) oxygen therapy in patients after extubation in the intensive care unit (ICU).
We retrospectively analyzed critically ill patients admitted to the ICU and subjected to HFNC or conventional oxygen therapy from January 2018 to June 2022 at the Suzhou Hospital of Integrated Traditional Chinese and Western Medicine. Blood gas analysis, a cough and sputum assessment, and cardiovascular function examinations were performed to evaluate the effect of HFNC oxygen therapy on patients. Also, the 28-d mortality rate, reintubation rate and incidence of respiratory failure were analyzed to evaluate whether HFNC oxygen therapy could improve patients' outcome.
In patients who received HFNC oxygen therapy, the partial pressure of oxygen and oxygenation index increased, and the respiratory rate decreased. HFNC oxygen therapy improved the patients' ability to cough up sputum and promoted the expulsion of sputum. In terms of cardiovascular function, patients who received HFNC oxygen therapy had a significant improvement in heart rate, but there was no real effect on patients' arterial pressure. There was no significant difference in the rates of reintubation (P = 0.202), 28-d mortality (P = 0.558) or respiratory failure (P = 0.677) between patients who received different oxygen therapies including HFNC oxygen therapy.
HFNC oxygen therapy improves the respiratory function of patients after extubation in their ICU and improves their coughing ability.
最佳氧供是危重症患者拔管后管理的基石。高流量氧疗系统是标准氧疗的一种替代方案。本研究探讨了高流量鼻导管(HFNC)氧疗在重症监护病房(ICU)患者拔管后的疗效。
我们回顾性分析了2018年1月至2022年6月在苏州市中西医结合医院ICU接受HFNC或传统氧疗的危重症患者。进行血气分析、咳嗽和痰液评估以及心血管功能检查,以评估HFNC氧疗对患者的效果。此外,分析28天死亡率、再插管率和呼吸衰竭发生率,以评估HFNC氧疗是否能改善患者的预后。
接受HFNC氧疗的患者,氧分压和氧合指数升高,呼吸频率降低。HFNC氧疗改善了患者咳痰能力,促进了痰液排出。在心血管功能方面,接受HFNC氧疗的患者心率有显著改善,但对患者动脉压无实际影响。接受包括HFNC氧疗在内的不同氧疗的患者之间,再插管率(P = 0.202)、28天死亡率(P = 0.558)或呼吸衰竭发生率(P = 0.677)无显著差异。
HFNC氧疗可改善ICU患者拔管后的呼吸功能,并提高其咳嗽能力。