Elsayed Rania G, Hafez Amr F, Maarouf Mohammed M, AbdElAziz Farouk Ke
Department of Anesthesia, ICU, and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Cairo, Egypt.
Department of Anesthesia and Critical Care, Faculty of Medicine, Ain Shams University, Cairo, Muhafazat al Qahirah, Egypt.
Indian J Crit Care Med. 2025 Feb;29(2):117-124. doi: 10.5005/jp-journals-10071-24904. Epub 2025 Jan 31.
Patients with pulmonary contusion (PC) following blunt chest trauma are at risk of developing acute lung injury. High-flow nasal cannula (HFNC) is an established method for managing hypoxic respiratory failure (HRF).
This study aims to evaluate the efficacy of oxygen therapy delivered through HFNC vs venturi mask (VM) in patients with hypoxia following traumatic lung contusion, to reduce the need for intubation and ventilation.
This is an open-label randomized controlled trial conducted on 120 patients with HRF following traumatic PC and a PaO/FiO of 100-200 mm Hg. Patients were divided into two groups: Group A (60 patients) received oxygen therapy through HFNC, while group B (60 patients) received oxygen therapy through VM.
High-flow nasal cannula significantly improved pulmonary oxygenation as early as 1 hour after randomization and the after with statistically significant improvement of PaO/FiO over time ( < 0.001). However, it was associated with a nonsignificant reduction in the rate of intubation and mechanical ventilation ( = 0.255) and a nonsignificant reduction in the mortality rate ( = 0.491). The extent of PC was found to be an independent predictor of mortality ( = 0.589) and length of hospital stay ( = 0.581) by multivariate analysis.
The early use of HFNC is associated with a significant improvement in pulmonary oxygenation. We suggest that HFNC can be used as a first-line oxygen therapy in hypoxic patients with lung contusion following blunt chest trauma.
Elsayed RG, Hafez AF, Maarouf MM, AbdElAziz FKE. Impact of the Early Use of High-flow Nasal Cannula in Patients with Post-traumatic Lung Contusion: A Randomized Clinical Trial. Indian J Crit Care Med 2025;29(2):117-124.
钝性胸部创伤后发生肺挫伤（PC）的患者有发生急性肺损伤的风险。高流量鼻导管（HFNC）是治疗低氧性呼吸衰竭（HRF）的一种既定方法。
本研究旨在评估经高流量鼻导管与文丘里面罩（VM）给氧疗法对创伤性肺挫伤后低氧患者的疗效，以减少插管和机械通气的需求。
这是一项开放标签的随机对照试验，对120例创伤性PC后发生HRF且动脉血氧分压/吸入氧分数值（PaO/FiO）为100 - 200 mmHg的患者进行研究。患者分为两组：A组（60例患者）通过HFNC接受氧疗，而B组（60例患者）通过VM接受氧疗。
高流量鼻导管在随机分组后1小时就显著改善了肺氧合，并且随着时间推移动脉血氧分压/吸入氧分数值有统计学意义的显著改善（P < 0.001）。然而，它与插管和机械通气率的非显著降低（P = 0.255）以及死亡率的非显著降低（P = 0.491）相关。多因素分析发现，PC的严重程度是死亡率（P = 0.589）和住院时间（P = 0.581）的独立预测因素。
早期使用HFNC与肺氧合的显著改善相关。我们建议，HFNC可作为钝性胸部创伤后肺挫伤低氧患者的一线氧疗方法。
Elsayed RG, Hafez AF, Maarouf MM, AbdElAziz FKE. 早期使用高流量鼻导管对创伤后肺挫伤患者的影响：一项随机临床试验。《印度重症医学杂志》2025；29(2):117 - 124。
