Comparative analysis of the use of high-flow and traditional oxygen therapy in patients with severe community-acquired pneumonia. An experimental and clinical study

Abstract

Introduction. In patients with spontaneous breathing and respiratory failure, various methods of delivering the gas mixture to the respiratory tract have been developed. The use of high-flow oxygen therapy is alternative standard oxygen therapy. Objectives. Experimental study of the effects of high-flow oxygen therapy and evaluation of its clinical effectiveness in comparison with traditional oxygen therapy in patients with severe community-acquired pneumonia. Materials and Methods. During the experimental stage of the study, the level of mean airway pressure was determined depending on the flow of the gas mixture using a lung model with parameters of biomechanics of respiration. During the clinical stage, a comparative analysis of the effectiveness of respiratory support in groups of patients with severe community-acquired pneumonia using high-flow and traditional oxygen therapy was carried out. Results. During experimental study, flow of gas mixture 30 l/min was determined, at which mean airway pressure registered on models of healthy lungs and lungs with modified respiratory biomechanics significantly increases. During the clinical phase of the study, a statistically significant decrease in the frequency of initiation of artificial (invasive and non-invasive) lung ventilation, an increase in oxygenation (saturation hemoglobin with oxygen, partial pressure oxygen in arterial blood) and partial pressure carbon dioxide with simultaneous decrease in respiratory rate. Conclusion. The value of gas flow over 30 l/min has significant effect on the recorded mean airway pressure calculated using models of lungs in experiment. However, clinical significance of this indicator is not clinically significant. The use of high-flow oxygen therapy in patients with severe community-acquired pneumonia in comparison with standard method reduces the frequency use of ventilation (invasive and non-invasive) with a significant increase in oxygenation indicators. This reduces hyperventilation, which is confirmed by a significant increase in partial pressure carbon dioxide and a decrease in respiratory rate.