A case study on how nasal high-flow treatment helps prevent the recurrence of surgical atelectasis by providing respiratory support

Abstract

Background: Preventing postoperative atelectasis in surgical patients with impaired pulmonary function is preferable. This study presented a case in which the use of nasal high flow treatment to assist the respiratory system prevented the recurrence of postoperative atelectasis. Case Presentation: An urgent laparoscopic procedure was performed on a 68-year-old man who had a perforation in his upper digestive tract. The patient appeared undernourished because of his severe, uncontrolled diabetes mellitus. The scheduled surgery was completed without incident. On the fifth postoperative day, the patient exhibited acute atelectasis of the left lower lobe, with an oxygen saturation of 89%. When tracheal suction and postural draining restored normal oxygenation, positive-pressure ventilation at 8 cm H2O airway pressure was employed to stop recurring atelectasis. On the seventh postoperative day, 15 hours after positive pressure breathing ended, the patient suffered a relapse of acute atelectasis. Once bronchoscopy was utilized to remove a mucous plaque from the tracheobronchial tree, nasal high flow treatment at a rate of 40 l/minute was employed to deliver a modest dose of continuous positive airway pressure rather than positive pressure breathing. The respiratory rehabilitation continued without a hitch, and his health was more stable with nasal high flow therapy's breathing support than it was with positive pressure ventilation. The nasal high flow therapy also provided gas that was sufficiently humidified, which improved the bronchial secretion. There was no new atelectasis throughout the remainder of the patient's stay in the intensive care unit. Conclusion: Respiratory support with nasal high flow treatment might help to prevent postoperative atelectasis by providing continuous positive airway pressure in conjunction with progressive respiratory rehabilitation.