PROS AND CONS OF A HIGH-FLOW NASAL OXYGEN THERAPY IN PATIENTS WITH RESPIRATORY FAILURE
DOI:
https://doi.org/10.31379/2411.2616.15.1.1Keywords:
respiratory failure; respiratory therapy; high-flow oxygen therapy; non-invasive lung ventilation; intensive care.Abstract
Objectives: to evaluate clinical efficiency of high-flow nasal oxygen therapy (HFNOT) in patients with respiratory failure. Methods: Prospective two-stage randomized clinical trial including 100 patients with I-II grade respiratory failure and community-acquired right-sided lower lobe pneumonia and posterior mediastinal gastro-esophogoplasty (GEP) with thoracoabdominal access and intrapleural anastomosis. At first stage HFNOT and non-invasive mask ventilation (NIMV) were compared for patients with communityacquired pneumonia. At second stage the use of HFNOT and standard respiratory therapy (RT) were evaluated for patients with (GEP). Following characteristics were analyzed: oxygenation index (PaO2/FiО2); arterial saturation (SaO2), chest X-ray and CT-scan; ventilation time; ventilation tolerability (scale from 1 to 10); conversion to mechanical ventilation frequency; ICU-stay. Results: Patients with community-acquired pneumonia better tolerated HFNOT (8±1 pts vs. 4±2 pts NIMV) with significantly longer ventilation time (up to 20 hrs. vs 3) and with comparable oxygenation index and arterial saturation. ICU-stay and conversion to mechanical ventilation were also comparable. At second stage patients after GEP had comparable oxygenation parameters, but they had lesser conversion to mechanical ventilation rate (15% vs. 22,5%), atelectasis rate (50 vs против 62,5%) and consequently shorter ICU-stay (12±4 vs. 18±3). Conclusion: HFNOT use in patients with respiratory failure shows clinical efficacy, is more tolerable by patients, but does not exclude other respiratory therapy methods.
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