Application Evaluation of High-Flow Humidified Oxygen in Patients with Respiratory Failure after General Anesthesia Extubation for Multiple Injuries.

Osamah Ibrahim Khalaf,Ruijuan Ci,Caizhe Ci,Chunhua Zhang,Mei Li,Shimin Dong,Yanjun Qin

doi:10.1155/2021/1387129

Osamah Ibrahim Khalaf, Ruijuan Ci + Show 5 more

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https://doi.org/10.1155/2021/1387129

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Abstract

Objective To explore the effect of high-flow humidified oxygen therapy (HFNC) on patients with respiratory failure after general anesthesia extubation for multiple injuries. Methods 214 patients with multiple injuries in our hospital who underwent general anesthesia and suffered respiratory failure after weaning extubation and received sequential treatment were included. And, they were divided into control group (HFNC group) and observation group (NIMV group) according to the random number table method. Patients in the control group (125 cases) used high-flow nasal cannula (HFNC) after general anesthesia extubation, while patients in the observation group (89 cases) used NIMV. The respiratory rate, heart rate, finger pulse oxygen, oxygenation index (PaO2/FiO2), and re-tracheal intubation rate in the two groups were compared at 2, 8, and 24 hours after sequential treatment, and the mortality rate and hospital stay of ICU time were whole-course observation. And, the effect of conventional oxygen inhalation or HFNC on oxygenation and prognosis was analyzed. Then, SPSS21.0 software was applied for statistical analysis. To analyze the effect of conventional oxygen inhalation or HFNC on the improvement of oxygenation and prognosis, the receiver operating characteristic (ROC) curve can be used to evaluate the feasibility and treatment effect of high-flow nasal oxygen therapy (HFNC) for patients with respiratory failure after general anesthesia extubation for multiple injuries. Results Compared with the NIMV group, the respiratory frequency and heart rate of the HFNC group were significantly improved after 2 h, 8 h, and 24 h. At the same time, the finger pulse oxygen and oxygenation index increased significantly and returned to normal levels. HFNC can significantly reduce the reintubation rate, ICU hospital stay, and mortality rate. The area under the ROC curve was 0.9102, with 95% CI (0.8256, 0.9949) and P < 0.0001. Conclusion For patients with multiple injuries undergoing general anesthesia and respiratory failure after weaning and extubation, the application of HFNC can moderate patients' heart rate and respiratory rate faster, increase oxygenation index and finger pulse oxygen, and reduce the reintubation rate, mortality rate, and ICU stay. At the same time, it can effectively improve the respiratory failure of patients after extubation and reduce the occurrence of complications.

Highlights

Multiple injuries refer to traumas to 2 or more organs and anatomical parts caused by a single injury [1]. e condition is complex, and the fatality rate is high
Patients with multiple injuries all have the same injury factor causing 2 or more anatomical injuries, the patients’ breathing state is relatively stable before treatment, and there is no symptom of respiratory failure. e patients were randomly divided into two groups, the control group (HFNC group, 125 cases) and the observation group
From December 2019 to February 2021, 214 patients with multiple injuries who were treated in our hospital were selected and suffered respiratory failure after general anesthesia extubation

Summary

Introduction

Multiple injuries refer to traumas to 2 or more organs and anatomical parts caused by a single injury [1]. e condition is complex, and the fatality rate is high. The anesthesia method needs to be selected according to the patients’ condition, trying our best to avoid the inhibition of circulation, breathing, and liver and kidney functions, thereby affecting the patients’ curative effect [3]. Respiratory failure is one of the serious complications after general anesthesia, and its incidence is as high as 3% [4]. Postoperative hypoventilation is one of the key causes of respiratory failure after general anesthesia, and upper abdominal surgery and chest surgery are more serious [7, 8]. Supplemental oxygen is one of the Journal of Healthcare Engineering first-line treatment methods for acute respiratory failure. Dry, low-temperature high-flow oxygen will cause upper respiratory tract dryness and affect the comfort that the patients feel [10, 11]

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