Efficacy analysis of sequential nasal high flow oxygen after extubation in patients with acute respiratory failure

Abstract

Objective To investigate the clinical efficacy of sequential nasal flow ventilation after extubation in patients with acute respiratory failure (referred to as respiratory failure). First of all, before and after extubation in HFNCO group, the respiratory parameters (PaO2, PaCO2, pH, lactic acid value, oxygenation index, HR, RR and LVEF) were compared with each other. The circulatory parameters (PaO2, PaCO2, pH, lactate, oxygenation index, HR, RR), clinical outcomes at the end of treatment / comorbidities (delirium, diarrhea, reintubation, ICU stay after extubation). Methods PaO2, PaCO2, pH value, lactate value at 1 h, 6 h, 12 h and 24 h after extubation in HFNCO group were not significantly different from those before extubation (all P> 0.05) (P 0.05). PaO2, PaCO2, pH and lactate value in HFNCO group and NIV group at 1 h, 6 h, 12 h and 24 h after extubation showed no significant difference (all P> 0.05). The effect of HFNCO on improving the oxygenation index after extubation was better than that of NPV group (P 0.05). The incidence of delirium in HFNCO group (18.18% vs. 41.67%) and ICU stay time after extubation (2.00 to 3.50) were statistically significant (all P <0.05). Results There were no significant differences in the arterial blood gas analysis (PaO2,PaCO2,pH, lactate value),PaO2, PaCO2, pH value, lactate value and LVEF at 1 h, 6 h, 12 h and 24 h before and after extubation in HFNCO group (all P> 0.05) Slightly higher than before extubation (0.59 ± 0.09 vs. 0.60 ± 0.09), the difference was not statistically significant (P> 0.05). PaO2, PaCO2, pH and lactate value in HFNCO group and NIV group at 1 h, 6 h, 12 h and 24 h after extubation showed no significant difference (all P> 0.05). The incidence of diarrhea (33.33% vs. 38.89%) and reintubation rate (6.1% vs. 13.9%) in HFNCO group were lower than those in NIV group (38.89%), but the difference was not statistically significant (all P> 0.05). The incidence of delirium (18.18% vs. 41.67%), and ICU stay time (2.00 to 3.50) in HFNCO group were significantly lower than those in NIV group (all P<0.05). Conclusions For acute respiratory failure patients after mechanical ventilation extubation, sequential administration of HFNCO and NIV can provide stable and effective oxygen therapy support; relative to the NIV, HFNCO can effectively improve patients oxygenation index, improve patient comfort and reduce the incidence of delirium And ICU stay time. Key words: Nasal high flow oxygen therapy; Acute respiratory failure; Noninvasive ventilation