Chilkoti Geetanjali T, Sehrawat Poonam, Mohta Medha, Gulabani Michell
UCMS & GTB Hospital, Clinic of Anaesthesiology, Delhi, India.
Turk J Anaesthesiol Reanim. 2025 Jul 16. doi: 10.4274/TJAR.2025.251895.
Postoperative pulmonary complication (PPC) is one of the leading causes of poor surgical outcome leading to longer hospital or intensive care unit stay and mortality especially with upper abdominal surgeries having long duration. High-frequency nasal oxygenation (HFNO) has recently been employed for postoperative oxygenation following extubation in surgical patients.
Fifty consenting adult patients aged 18-65 years of either sex scheduled for exploratory abdominal surgeries under general anaesthesia (GA) with Assess Respiratory Risk in Surgical Patients in Catalonia score ≥ 26 i.e., moderate to high risk were enrolled. After instituting all routine the American Society of Anesthesiologists recommended monitoring, baseline haemodynamic parameters were recorded. Patients were preoxygenated with 100% oxygen and GA was administered as per standard institutional protocol. Following extubation, patients were randomly allocated into one of the groups comprising 25 patients each where Group C and Group H received conventional oxygen therapy via simple face mask and HFNO respectively. The FiO was titrated (from 45% to 100%) by the anaesthesiologist to maintain a SpO of 95% or more. Arterial blood samples were collected after extubation at various designated time points i.e. 2, 6,12 and 24 hr, The P/F ratio, PaO, PaCO, S/F ratio along with haemodynamic parameters, incidence of PPCs/acute hypoxemic respiratory failure (AHRF), atelectasis and comfort score were also recorded.
Significant improvement in all oxygenation parameters following the use of HFNO for postoperative oxygenation; however, PaCO, haemodynamic variables, complications, incidence of PPCs/AHRF and atelectasis remained comparable between the two groups.
Preventive use of HFNO for post operative oxygenation amongst moderate to high-risk patients scheduled for exploratory abdominal surgery improves oxygenation.
术后肺部并发症（PPC）是导致手术预后不良的主要原因之一，会导致住院时间或重症监护病房停留时间延长以及死亡率增加，尤其是长时间的上腹部手术。高频鼻导管给氧（HFNO）最近已被用于外科手术患者拔管后的术后氧疗。
纳入50例年龄在18 - 65岁、同意接受全身麻醉（GA）下探索性腹部手术的成年患者，加泰罗尼亚外科患者呼吸风险评估评分≥26，即中度至高度风险。在进行美国麻醉医师协会推荐的所有常规监测后，记录基线血流动力学参数。患者用100%氧气进行预充氧，并按照标准机构方案给予全身麻醉。拔管后，患者被随机分为两组，每组25例，C组和H组分别通过简易面罩和高频鼻导管给氧接受传统氧疗。麻醉医生将FiO₂滴定（从45%至100%）以维持SpO₂在95%或更高。在拔管后的不同指定时间点，即2、6、12和24小时采集动脉血样本，记录P/F比值、PaO₂、PaCO₂、S/F比值以及血流动力学参数、PPCs/急性低氧性呼吸衰竭（AHRF）的发生率、肺不张和舒适度评分。
使用高频鼻导管给氧进行术后氧疗后，所有氧合参数均有显著改善；然而，两组之间的PaCO₂、血流动力学变量、并发症、PPCs/AHRF的发生率和肺不张仍具有可比性。
对于计划进行探索性腹部手术的中度至高度风险患者，预防性使用高频鼻导管给氧进行术后氧疗可改善氧合。
