Sequential therapy with high-flow nasal cannula oxygen in patients with acute respiratory failure

Abstract

Objective To determine the efficacy of sequential therapy with high-flow nasal cannula oxygen in patients with acute respiratory failure. Methods Acute respiratory failure patients admitted to department of Crititcal Care Medicine of Affiliated Hospital of Nantong University who received mechanical ventilation from January 2016 to December 2017 were enrolled in this study. After extubation, 44 patients were randomly divided into control group while 45 others in high flow oxygen group. The control group was given conventional oxygen therapy (nasal catheter or mask), and high flow group was treated with high-flow nasal cannula oxygen. Respiratory rate, PaO2/FiO2, SaO2 and PaCO2 of patients at 1h, 8h and 24h after extubation between two groups were recorded. We also recorded the comfort level and tolerance of oxygen therapy, the proportion of noninvasive ventilation and re-intubation between two groups. Results The respiratory rate ( per minute) was significantly lower in the high-flow oxygen group [1 h: (20.6±3.2) times/min vs (24.5±3.7) times/min; 8 h: (21.5±3.6) times/min vs (20.6±3.2) times/min; 24 h: (20.9±3.4) times/min vs (24.9±4.2) times/min, all P 0.05). Conclusion In patients with acute respiratory failure after extubation, treatment with high-flow oxygen can improveoxygenationwith better comfort and tolerance. Also it can reduce the use of noninvasive mechanical ventilation in patients. The findings support the use of high-flow nasal oxygen therapy as sequential therapy after extubation in patients with acute respiratory failure. Key words: High-flow nasal cannula oxygen therapy; Acute respiratory failure; Sequential therapy