Therapeutic effects of high-flow nasal cannula oxygen therapy versus non-invasive positive pressure ventilation in patients with type I respiratory failure(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2019年第9期
- Page:
- 1077-1081
- Research Field:
- 医学生物物理
- Publishing date:
Info
- Title:
- Therapeutic effects of high-flow nasal cannula oxygen therapy versus non-invasive positive pressure ventilation in patients with type I respiratory failure
- Author(s):
- ZHAO Haiyun; PENG Simiao; OU Jin’nan; LI Lezhi
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital of Central South University, Changsha 410011, China
- Keywords:
- ; Keywords: high flow nasal cannula oxygen therapy; non-invasive positive pressure ventilation; respiratory failure; respiratory rate; oxygenation index; swallowing function
- PACS:
- R563.8
- DOI:
- DOI:10.3969/j.issn.1005-202X.2019.09.016
- Abstract:
- Abstract: Objective To compare the clinical effects of high-flow nasal cannula oxygen therapy (HFNC) and non-invasive positive pressure ventilation (NPPV) in patients with type I respiratory failure. Methods A total of 160 patients with type I respiratory failure who were treated in the Second Xiangya Hospital of Central South University from April 2016 to June 2018 were enrolled in the study and randomly divided into NPPV group and HFNC group, with 80 patients in each group. Duration of no ventilator during hospitalization, tracheal intubation within 28 days, 30-day mortality and total hospital stay were analyzed between two groups. Moreover, the respiratory rate and oxygenation index at different treatment time points (from 0 to 48 h), and pain, abdominal distension, swallowing function, nutritional support routes in two groups were monitored. Results The results of water swallow test showed that the swallowing function of HFNC group was significantly better than that of NPPV group (P<0.05). The number of patients treated with tracheal intubation within 28 days and 30-day mortality in HFNC group were significantly lower than those in NPPV group (P<0.05), and the total hospital stay was significantly shorter than that in NPPV group (P<0.05), while the duration of no ventilator were similar in two groups (P>0.05). There was no statistically significant difference between HFNC group and NPPV group in nutritional support route (total oral feeding, oral feeding, enteral/parenteral nutrition, total parenteral nutrition) (P>0.05). The incidence of abdominal distension was 5.50% in HFNC group, significantly lower than 22.50% in NPPV group (P<0.05). The respiratory rate of two groups decreased gradually with the prolongation of treatment time, and at different treatment time points (6, 24, 48 h), the respiratory rate was significantly less than that at 0 h treatment (P<0.05). As the treatment time prolonged, the oxygenation index at different treatment time points (6, 24, 48 h) was significantly greater than that at 0 h treatment (P<0.05). Meanwhile, the respiratory rate of HFNC group at different treatment time points (6, 24, 48 h) was significantly lower than that of NPPV group (P<0.05), and there was no significant difference in the oxygenation index between two groups at different treatment time points (6, 24, 48 h) (P>0.05). Conclusion Compared with NPPV, HFNC in patients with type I respiratory failure has a lower incidence of abdominal distension, and less effect on swallowing function. The comparison of NPPV and HFNC also shows that after the treatment of HFNC, there are fewer cases of tracheal intubations in 28 days, lower 30-day mortality, and remarkably improved respiratory rate and oxygenation index. In conclusion, HFNC has high clinical application value.
Last Update: 2019-09-23