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床上骑行联合高流量鼻导管治疗对重度呼吸衰竭患者动脉血氧及呼吸动力学的影响:一项回顾性研究。

The effect of in-bed cycling combined with high flow nasal cannula treatment on arterial oxygen and respiratory dynamics in patients with severe respiratory failure: A retrospective study.

作者信息

Wang Xiaoyan, Zhang Jiapo, Jiang Yang, Liu Jie, Huo Deyuan

机构信息

Xiaoyan Wang Department of Thoracic Surgery, Xiamen University Institute of Chest and Lung Disease, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian Province, P.R. China.

Jiapo Zhang Department of Emergency Medicine, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian Province, P.R. China.

出版信息

Pak J Med Sci. 2024 Sep;40(8):1813-1818. doi: 10.12669/pjms.40.8.9471.

Abstract

OBJECTIVE

To assess the effects of in-bed cycling (IBC) combined with high flow nasal cannula (HFNC) on arterial oxygen and respiratory dynamics in patients with severe respiratory failure (RF).

METHODS

We retrospectively collected clinical data of 103 patients with severe RF, admitted to the intensive care unit (ICU) of The Second Affiliated Hospital of Harbin Medical University from March 2021 to March 2023. Among them, 50 patients had HFNC alone (control group), and 53 patients did IBC in addition to HFNC (observation group). We compared arterial oxygen index, lung function, respiratory dynamics, and clinical efficacy between the two groups.

RESULTS

There was no significant difference in the basic data between the two groups (>0.05). After the treatment, the improvement of the partial pressure of oxygen (PaO), PaO/fraction of inspired oxygen (FiO), arterial oxygen saturation (SaO), and oxygen delivery (DO) in the observation group was significantly better than that in the control group (<0.05). After the treatment, the improvement of lung function in the observation group was better than that in the control group (<0.05). After the treatment, the end expiratory pulmonary pressure (P) and driving pressure (△P) levels in the observation group were significantly higher, and the duration of ICU hospitalization and the incidence of ICU-acquired weakness(ICU-AW) were significantly lower than those in the control group (<0.05).

CONCLUSIONS

IBC combined with HFNC can significantly improve arterial oxygen levels, lung function, and respiratory dynamics in patients with severe RF. IBC in combination with HFNC is associated with shorter stay time in the ICU, reduced of ICU-acquired weakness, and better physical recovery of patients.

摘要

目的

评估床上骑行(IBC)联合高流量鼻导管(HFNC)对严重呼吸衰竭(RF)患者动脉氧合及呼吸动力学的影响。

方法

回顾性收集2021年3月至2023年3月哈尔滨医科大学附属第二医院重症监护病房(ICU)收治的103例严重RF患者的临床资料。其中,50例患者仅接受HFNC治疗(对照组),53例患者在接受HFNC治疗的基础上进行IBC(观察组)。比较两组患者的动脉氧合指数、肺功能、呼吸动力学及临床疗效。

结果

两组患者的基础资料比较,差异无统计学意义(>0.05)。治疗后,观察组患者的氧分压(PaO)、PaO/吸入氧分数(FiO)、动脉血氧饱和度(SaO)及氧输送量(DO)的改善情况均显著优于对照组(<0.05)。治疗后,观察组患者的肺功能改善情况优于对照组(<0.05)。治疗后,观察组患者的呼气末肺压(P)及驱动压(△P)水平显著升高,ICU住院时间及ICU获得性肌无力(ICU-AW)的发生率显著低于对照组(<0.05)。

结论

IBC联合HFNC可显著改善严重RF患者的动脉氧水平及肺功能和呼吸动力学。IBC联合HFNC可缩短患者在ICU的停留时间,降低ICU获得性肌无力的发生率,促进患者身体恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbac/11395357/34265b50e3a4/PJMS-40-1813-g001.jpg

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