High Flow Nasal Cannula Decreased Pulmonary Complications in Neurologically Critically Ill Patients.

Shuanglin Wang,Peng Zhang,Jingjing Yang,Zheng Zachory Wei,Bing Yang,Yanli Xu,Huayun Yin,Yingying Zhao

doi:10.3389/fnhum.2021.801918

Abstract

Objective: Pulmonary complications could badly affect the recovery of neurological function and neurological prognosis of neurological critically ill patients. This study evaluated the effect of high-flow nasal cannula (HFNC) therapy on decreasing pulmonary complications in neurologically critically ill patients.Patients and Methods: The patients admitted to the intensive care unit (ICU) with serious neurological disease and receiving oxygen therapy were retrospectively reviewed (Ethical No. IRB2021-YX-001). Patients were divided into the HFNC group and the conventional oxygen therapy (COT) group. We analyzed the data within these two groups, including patients’ baseline data, short-term outcomes of respiratory complications, general outcomes including hospital stay, ICU stay and mortality, and neurological functions. To analyze the relevant factors, we performed multivariable logistic regression analysis.Results: A total of 283 patients met the criteria, including 164 cases in the HFNC group and 119 cases in the COT group. The HFNC group had remarkably less mechanical ventilation requirement with lower phlegm viscosity. Even more, ICU stay and total hospital stay were significantly shortened in the HNFC group.Conclusion: HFNC decreased pulmonary complications in neurologically critically ill patients and improved recovery of neurological function and neurological prognosis.

Highlights

The neurologically critically ill patient is more susceptible to pulmonary complications, such as hypostatic pneumonia, acute respiratory distress syndrome (ARDS), aspiration pneumonia and pulmonary atelectasis (Stueber et al, 2017)
High-flow nasal cannula (HFNC) therapy involved a new heated and humidified system consisting of an air-oxygen blender, and a heated humidification equipment
Developing a multivariable logistic regression model to analyze short-term neurological outcomes, we found that oxygen therapy was an important factor (p < 0.010) (Table 6), which indicates that oxygen therapy had an important effect on shortterm neurological prognosis

Summary

Introduction

The neurologically critically ill patient is more susceptible to pulmonary complications, such as hypostatic pneumonia, acute respiratory distress syndrome (ARDS), aspiration pneumonia and pulmonary atelectasis (Stueber et al, 2017). High Flow Nasal Cannula Therapy critically ill patients (Gaddam et al, 2015). We try to explore an efficient way to reduce pulmonary complications and improve respiratory function, benefiting patients with neurologically critical conditions. High-flow nasal cannula (HFNC) therapy involved a new heated and humidified system consisting of an air-oxygen blender, and a heated humidification equipment. Compared with Venturi-type masks, HFNC could provide a higher concentration of oxygen, more steady oxygen flow, better humidification function and reduce the workload of breathing (Chanques et al, 2013; Rittayamai et al, 2014). HFNC could improve patients’ functional residual capacity (FRC) (Maggiore et al, 2014)

Methods

Results

Conclusion