Effects of high-flow nasal oxygen vs noninvasive positive airway pressure in hypoxemic patients after surgery

Abstract

Objective To prospectively investigate the effects of high-flow nasal oxygen on hypoxemic patients after surgery. Methods A total of 108 postoperation hypoxemic patients (150 mmHg≤PaO2/FiO2<300 mmHg, PaCO2≤50 mmHg) in Beijing Hospital Surgical Intensive Critical Unit was included and assigned randomly to two groups from June 2016 to April 2017. Fifty four patients (study group) who received high-flow nasal oxygen therapy were compared with 54 patients (control group) who received noninvasive ventilation therapy. The data of reintubation and mortality in 28 days after extubation were collected and analyzed. Results No significant differences were found for reintubation rate (11.1% vs 13.0%, P=0.767) and mortality (5.6% vs 7.4%, P=0.696) in 28 days after extubation between two groups. In subgroup analysis, no significant differences were found for different hypoxima level (250 mmHg≤PaO2/FiO2<300 mmHg, 200 mmHg≤PaO2/FiO2<250 mmHg and 150 mmHg≤PaO2/FiO2<200 mmHg) between two groups, for reintubation rate (0 vs 3.7%, P=0.296; 20% vs 14.3%, P=0.684; 30% vs 30.8%, P=0.968, respectively) and mortality (0 vs 3.7%, P=0.296; 6.7% vs 7.1%, P=0.960; 20% vs 15.4%, P=0.772, respectively). Face skin breakdown were significantly more common in control group (11.1% vs 0, P=0.012). Conclusions High-flow nasal oxygen therapy was not inferior to noninvasive ventilation for mild and moderate hypoxemic patients after surgery. High-flow nasal oxygen therapy is safe and effective for these patients. Key words: Oxygen inhalation therapy; Positive-pressure respiration; Anoxia/TH; Postoperative complications/TH