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

Article Contents

Article Navigation > Journal of Kunming Medical University > 2017 > 38(01): 65-69

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.

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.

PDF( 199 KB)

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

Funds:

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

FullText(HTML)

References(12)

References

[1]	[1]FRUTOS-VIVAR F, ESTEBAN A, APEZTEGUIA C, et al.Outcome of reintubated patients after scheduled extubation[J].J Crit Care, 2011, 26 (5) :502-509.
[2]	[2]PATEL KANULESH, FATEMEH HADIAN, ALI AYSHA, et al.Postoperative pulmonary complications following major elective abdominal surgery:a cohort study[J].Perioperative Medicine, 2016, 5 (10) :2-7.
[3]	[3]RICARD J D.High flow nasal oxygen in acute respiratory failure[J].Minerva Anesthesi, 2012, 78 (7) :836-841.
[4]河北省新生儿加温湿化高流量鼻导管通气研究协作组.应用加温湿化高流量鼻导管通气预防新生儿拔管失败的临床研究[J].中华儿科杂志, 2014, 52 (4) :271-276.
[5]尹明, 沈洪.经鼻导管湿化高流量吸氧能否减少呼吸衰竭成人患者的插管率[J].中国危重疾病急救医学, 2012, 24 (2) :68-69.
[6]	[6]PARKE RACHAEL L, ECCLESTON MICHELLE L, MCGUINNESS SHAY P, et al.The effects of flow on airway pressure during nasal high-flow oxygen therapy[J].Respir Care, 2011, 56 (8) :1151-1155.
[7] 吕姗, 安友仲.主动湿化的经鼻高流量氧疗在成人患者中的运用[J].中华危重病急救医学, 2016, 28 (1) :1151-1155.
[8]	[8]NISHIMURA MASAGI.High-flow nasal cannual oxygen therapy in adults[J].Journal of Intensive Care, 2015, 3 (15) :1-8.
[9]	[9]ITAGAKI TAIGA, OKUDA NAO, TSUNANO YUMIKO, et al.Effect of high-flow nasal cannula on thoraco-abdominal synchrony in adult critically ill patients[J].Respir Care, 2014, 59 (1) :70-74.
[10]	[10]FRAT JEAN-PIERRE, THILLE ARNAND W, MERCAT ALAIN, et al.High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure[J].N Eng J Med, 2015, 372 (23) :2185-2196.
[11]	[11]DROTFAIN EVGENI, ZLOTNIK ALENXANDER, ANDREI SCHWARTZ, et al.Comparison of the effectiveness of high flow nasal oxygen cannula vs standard care unite opatients[J].IMAJ, 2014, 16 (11) :718-722.
[12]王长捷, 段皎, 罗光辉, 等.无创持续气道正压应用于老年I型呼吸衰竭病人的临床观察研究[J].昆明医学院学报, 2011, 32 (11) :118-123.

Relative Articles(20)

Relative Articles

[1]	Maoliang TIAN, Boxue HAN, Jiamei WANG, Zheng ZONG, Zhiping DENG. Effects of AVAPS-AE Mode of Non-invasive Ventilation on PSG Parameters，ESS Score and Comfort in Patients with AECOPD and OSA. Journal of Kunming Medical University, 2024, 45(4): 105-112. doi: 10.12259/j.issn.2095-610X.S20240415
[2]	Caiying ZHANG, Zhengping KUI, Qiong WANG, Xiaolong ZHAO, Xiaomei HOU, Zhiye QI. Perinatal Risk Factors of Neonatal Hyperthyrotropinemia. Journal of Kunming Medical University, 2022, 43(9): 48-52. doi: 10.12259/j.issn.2095-610X.S20220929
[3]	Xiaoxue LIU, Li YANG, Chuanyun QIAN. Application of High-flow Nasal Cannula Oxygen Therapy in High-altitude Hypoxemia. Journal of Kunming Medical University, 2022, 43(12): 88-92. doi: 10.12259/j.issn.2095-610X.S20221216
[4]	Wang Ying , Sun Hai Mei , Tang Kun , Dai Rong . . Journal of Kunming Medical University, 2020, 41(08): 134-138.
[5]	Xiao-zhi XU, Jing-hui YANG. Comparison of Exchange Transfusion and Intensive Phototherapy in the Treatment of Neonatal Hyperbilirubinemia. Journal of Kunming Medical University, 2020, 41(11): 44-48. doi: 10.12259/j.issn.2095-610X.S20201131
[6]	Lou Fan , Zhang Tie Song , Ma Jing , Lin Ken , Zhao Li Ping . . Journal of Kunming Medical University, 2020, 41(07): 94-98.
[7]	Zeng Xiao Ying , Zhang Chuan , Le Tao , Jiang Li Dong , Wang Xi , Ye Dan , Ke Li , Zhang Yi . . Journal of Kunming Medical University, 2019, 40(12): 80-85.
[8]	Chen Hong Mei , Liu Li . . Journal of Kunming Medical University, 2019, 40(07): 116-119.
[9]	Xu Li Jie , Pan Ling , Fan Yan Qian , Li Hui Fang , Lei Ying , Li Min . . Journal of Kunming Medical University, 2019, 40(02): 97-101.
[10]	Zhang Le , Xia Jia Wei , Chen Hai Yun , Huang Ying . . Journal of Kunming Medical University, 2018, 39(11): 93-97.
[11]	Du Ru Fei , Ding Wei Xing , Liu Yun Song , Zhang Can Hua . . Journal of Kunming Medical University, 2017, 38(05): 125-128.
[12]	Lai 碁. The Application Time of NIMV Treatment in ACS Patients with Hypoxaemia. Journal of Kunming Medical University,
[13]	Kui Ze Hong . . Journal of Kunming Medical University,
[14]	Dai Bai Zhang . . Journal of Kunming Medical University,
[15]	He Xue Zhong . . Journal of Kunming Medical University,
[16]	Ling Da Qing . . Journal of Kunming Medical University,
[17]	Wang Ya Nan . . Journal of Kunming Medical University,
[18]	Fei Xian Min . . Journal of Kunming Medical University,
[19]	Wang Zhi Hua . Correlation between Micro-inflammation State and Cardiovascular Complications in Patients with Maintenance Hemodialysis. Journal of Kunming Medical University,
[20]	. Effects of Midazolam Combined with Morphine in the Treatment of COPD Patients who Received Invasive Ventilation. Journal of Kunming Medical University,