Abstract
We thank Dr Nachira and colleagues [1Nachira D. Congedo M.T. Ferretti G.M. Margaritora S. Bello G. High-flow nasal oxygen after lung resection: can it be helpful? (letter).Ann Thorac Surg. 2016; 102: 1410-1411Abstract Full Text Full Text PDF Scopus (1) Google Scholar] for their letter and for enlightening us about their ongoing interesting trial in patients after thoracotomy. Just more than half of the patients in our trial underwent thoracotomy, whereas the rest underwent video-assisted thoracoscopic operations. We are pleased that other groups are also investigating the utility of high-flow nasal oxygen after thoracic operations [2Ansari B.M. Hogan M.P. Collier T.J. et al.A randomized controlled trial of high-flow nasal oxygen (Optiflow) as part of an enhanced recovery program after lung resection surgery.Ann Thorac Surg. 2016; 101: 459-464Abstract Full Text Full Text PDF Scopus (50) Google Scholar], and we are now conducting a similar trial in patients with respiratory disease after cardiac procedures [3Zochios V. Klein A. Jones N. et al.Rationale and design of a randomised controlled trial of high-flow nasal oxygen (Optiflow) and standard oxygen therapy in high-risk patients after cardiac surgery.J Cardiol Clin Res. 2015; 3: 1045Google Scholar]. During our preliminary investigations before planning our randomized controlled trial, we also found that Pao2:fraction of inspired air ratios were not altered a great deal using high-flow compared with standard oxygen therapy; hence we decided not to use it as a primary outcome measure in our studies. Instead, as described, we found that patients felt subjectively better and less short of breath and were able to mobilize quicker and go home earlier, but only when used as part of an enhanced recovery program. Having successfully introduced and studied our enhanced recovery program including a multidisciplinary focus on outcomes after surgical procedures, we now investigate the effect of further changes to our pathway individually [4Giménez-Milà M. Klein A.A. Martinez G. Design and implementation of an enhanced recovery program in thoracic surgery.J Thorac Dis. 2016; 8: S37-S45Google Scholar]. We look forward to the final results from Nachira and colleagues [1Nachira D. Congedo M.T. Ferretti G.M. Margaritora S. Bello G. High-flow nasal oxygen after lung resection: can it be helpful? (letter).Ann Thorac Surg. 2016; 102: 1410-1411Abstract Full Text Full Text PDF Scopus (1) Google Scholar] and those of other researchers investigating the utility of high-flow nasal oxygen after major operations [5Zochios V. Klein A.A. Jones N. Kriz T. Effect of high-flow nasal oxygen on pulmonary complications and outcomes after adult cardiothoracic surgery: a qualitative review.J Cardiothorac Vasc Anaes. 2015 Dec 18; ([Epub ahead of print])http://dx.doi.org/10.1053/j.jvca.2015.12.023Google Scholar]. High-Flow Nasal Oxygen After Lung Resection: Can It Be Helpful?The Annals of Thoracic SurgeryVol. 102Issue 4PreviewWe read with great interest the article by Ansari and colleagues [1] showing that high-flow nasal cannula oxygen (HFNC) treatment cannot improve the 6-minute walk test after lung resection but can reduce the length of hospitalization and improve patient satisfaction when compared with standard oxygen therapy. Although the role of HFNC in the intensive care unit has been widely investigated [2, 3], the literature remains scarce on the use of HFNC in low-intensity medical care units and wards [4], particularly after lung operations. Full-Text PDF
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