Research on the effectiveness between high flow nasal oxygen cannula and non-rebreather oxygen face mask in post-extubation patients

Abstract

Objective To compare the clinical effects of high flow nasal cannula (HFNC) and non-rebreathing oxygen face mask(NRB) in post-extubation patients. Methods 88 critically ill patients with machinery ventilations were divided into HFNC group and NRB group randomly. Blood gas analysis and hemodynamic parameters were assessed 1 hour prior to extubation and 6 hours after extubation. The primary clinical outcomes measured were ventilation-free days, re-intubation patient numbers, length of stay in ICU(Intensive Care Unite) , total duration of hospitalization and mortality. The scant of breath degree and comfortableness of patient were recorded according to the Visual analogue scale. The measurement data were described by mean±standard deviation (±s) and analyzed with t test, enumeration data were described by number of cases and composition ratio and analyzed with χ2test, P<0.05 was considered to have statistical difference. Results There was no significant difference in clinical features between the two groups, The oxygenation index of HFNC group is significantly higher than that of NRB group after extubation [(251.4±43.9) vs.(201.7±60.7), P=0.037)]. There were more ventilator-free days in the HFNC group than NRB group [(4.2± 2.1) vs.(3.4±2.8), P=0.037)] and fewer patients required re-intubation(P=0.028). The rate of ventilator associated pneumonia is also lower than NRB group(P=0.024). The patients’ scant of breath feeling were obviously allevated comparing with the NRB group [(2.9±1.1) vs.(3.7±1.8), P=0.042)]. The oxygenation index of NRB group significantly decreased after extubation[(242.9±68.4vs.201.7±60.7 P=0.048)]. The two groups demonstrated similar hemodynamic patterns before and after extubation. And there were no statistically significant clinical differences in PaCO2, length of ICU stay, total duration of hospitalization or mortality. Conclusions Compared with NRB, HFNC is a more safe and effective clinical tool in the prevention and treatment of critical adult patients with extubation failure. Key words: High flow nasal cannula (HFNC); Non-rebreathing oxygen face mask (NRB); Post-extubation respiratory failure; Mechanical ventilation; Extubation; Curative effect