Efficacy and airway management of humidified high flow nasal cannula oxygen therapy in treatment of postoperative acute respiratory failure after extubation

Abstract

Objective To investigate the clinical efficacy of the humidified high flow nasal cannula oxygen therapy (HHFNC) in treatment of postoperative acute respiratory failure (ARF) after extubation. Methods Eighty-six postoperative ARF patients after extubation in August 2014 to December 2015 in ICU were selected and randomly divided into A (44 cases) and B (42 cases) groups, group A received HHFNC therapy, group B received bi-level positive airway pressure ventilation (BiPAP). Basic vital signs and arterial blood gas indexes were observed after 2 h auxiliary ventilation, and noninvasive ventilation duration, incidences of reintubation and ventilator-associated pneumonia (VAP) of the 2 groups were compared. Results After 2 h noninvasive ventilation treatment, 2 groups of patients with heart rate (HR), respiratory ratio (RR), oxygen saturation (SpO2), oxygen partial pressure (PaO2), partial pressure of carbon dioxi (PaCO2) were all improved, group A with increasing of SpO2 (8.2±1.8 vs 7.4±1.5)% and PaO2 (20.5±3.3 vs 18.3±3.0) mmHg and decreasing of RR (9.4±2.1 vs 7.3±1.9) beats/min, PaCO2 (6.2±1.9 vs 5.1±1.6) mmHg were both significantly higher than group B (P 0.05). Conclusions Compared with BiPAP, HHFNC in treatment of ARF after extubation can quickly improve oxygenation and reduce carbon dioxide retention, besides, can reduce ventilation duration, and the efficacy of avoiding reintubation is at least not inferior to BiPAP. Key words: Respiratory insufficiency; Positive-pressure respiration; Intubation, gastrointestinal; Humidified high flow nasal cannula oxygen therapy