Comparison between Nasal High Flow Oxygen Therapy and Non-invasive Ventilation Care for Post-extubation Hypoxemia after Abdominal Surgery in ICU

Li Zhi Wei; Li Chao; Dong Quan; Ma Ji Tao; Wang Li Lan; Li Yang; Zhang Hong Xing; Yang Li Na

Volume 38 Issue 01

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Li Zhi Wei , Li Chao , Dong Quan , Ma Ji Tao , Wang Li Lan , Li Yang , Zhang Hong Xing , Yang Li Na . Comparison between Nasal High Flow Oxygen Therapy and Non-invasive Ventilation Care for Post-extubation Hypoxemia after Abdominal Surgery in ICU[J]. Journal of Kunming Medical University, 2017, 38(01): 65-69.

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Li Zhi Wei , Li Chao , Dong Quan , Ma Ji Tao , Wang Li Lan , Li Yang , Zhang Hong Xing , Yang Li Na . Comparison between Nasal High Flow Oxygen Therapy and Non-invasive Ventilation Care for Post-extubation Hypoxemia after Abdominal Surgery in ICU[J]. Journal of Kunming Medical University, 2017, 38(01): 65-69.

Citation:

Li Zhi Wei , Li Chao , Dong Quan , Ma Ji Tao , Wang Li Lan , Li Yang , Zhang Hong Xing , Yang Li Na . Comparison between Nasal High Flow Oxygen Therapy and Non-invasive Ventilation Care for Post-extubation Hypoxemia after Abdominal Surgery in ICU[J]. Journal of Kunming Medical University, 2017, 38(01): 65-69.

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Comparison between Nasal High Flow Oxygen Therapy and Non-invasive Ventilation Care for Post-extubation Hypoxemia after Abdominal Surgery in ICU

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基金：云南省教育厅科学研究基金资助项目 (2015Z083);

Received Date: 2016-09-20

Abstract

Abstract

Objective To compare the clinical effects between nasal high flow oxygen therapy and non-invasive ventilation care for post-extubation mild-to-moderrate hypoxemia after abdominal surgery In ICU.Methods Forty-eight patients with post-extubation hypoxemia after abdominal surgery in our ICU were randomly divided into 2 groups: high flow oxygen therapy group and non-invasive ventilation group.Patients in the two groups were treated with HFNV and NIV, respectively, for 1 day.Then we compared the data including: 1.objective respiratory and circulatory parameters (R, PaO2/FIO2, PaCO2;MABP) during at pre-extubation (T0) and post- extubation 30 minuts (T1/2) and the 24 hours (T24) as well as a subjective rating of dyspnea and discomfort by the patients on a number10-points scale of 0 (lowest) to 10 (highest) in the end of 24 h observation period;2. Devices related benign side effects (nose and mouth dryness, skin pressure redness or ulcer, nose or mouth mucosal lesions, thirsty.3. ICU stay and mortality.Results There were no significant differences in the baseline characteristics of the patients between two groups including age, sex, APACHEII score, SOFA score, major etiology and previous illnesses ratio, pre-extubation mechanic ventilation times, P>0.05) ;the PaO2/FIO2 in NIV group at T1/2, T24 were better than HFNV group (222±36.5) , (267±88.9) mm Hg versus (195±23.4) , (224±82.7) mm Hg, P<0.05;T0, T1/2, T24 the circulatory parameters and others respiratory parameters had no significant differences, P >0.05; in contrast, on getting the number10-points scale of 0 (lowest) to 10 (highest) in the final study time interview from the patients, HFNV group (5.7±2.8) was significantly better than NIV group (2.8±1.5) , P<0.05.Devices related side effects in the NIV group (14 cases, 58.3%) was more obvious than the HFNV group (4 cases, 16.7%, P<0.01) ;3 cases, 12.5% in group NIV were changed to HFNV care, in contrast, there was no case changed to the NIV treatment, P<0.05;without any cases in two groups, they were reintubated for invasive ventilation.One old male case in HFNC group died from acute myocardial infarction, but there was no significant differences in ICU stay and mortality.Conclusion Compared with the NIV, in general, the HFNC therapy may offer a better choice for post-extubation mild-to-moderrate hypoxemia after abdominal surgery in ICU.
- Nasal high flow oxygen therapy,
- Non-invasive ventilation care,
- Hypoxemia,
- Abdominal surgery,
- Intensive care medicine

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References

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