Clinical application of high-flow nasal cannula for the respiratory failure following radical resection of pulmonary carcinoma
10.3760/cma.j.issn.1672-7088.2017.30.004
- VernacularTitle:经鼻导管高流量氧疗在肺癌根治术后呼吸衰竭患者中的临床应用
- Author:
Ting SUN
1
,
2
;
徐州医科大学急救与救援医学系
;
Hulin ZHU
Author Information
1. 徐州医科大学附属医院护理部 221000
2. 徐州医科大学急救与救援医学系
- Keywords:
The high flow oxygen nasal catheter therapy;
Postoperative lung cancer;
Respiratory failure;
Hypoxemia
- From:
Chinese Journal of Practical Nursing
2017;33(30):2334-2338
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effects of the application of high-flow nasal cannula (HFNC)for the respiratory failure following radical resection of pulmonary carcinoma. Methods A total of 48 patients with radicalsurgeryofpulmonarycarcinoma effect postoperative failure from February 2015 to August 2016 were randomly divided into observation group(24 cases) and control group(24 cases) with digital table method.The observation group was received with HFNC,and the control group with oxygen atomization mask 8-10 L/min.The heart rate,respiratory rate,PaO2,PaCO2and oxygenation index(PaO2/FiO2)changes were evaluated before treatment,treatment for 1,6,24 h and at the end of the treatment in both groups, at the same time, noninvasive positive pressure ventilation (NPPV) rate, again intubation mechanical ventilation rate, incidence of ventilator associated pneumonia (VAP), ICU confusion assessment (CAM-ICU) positive rates and ICU stay time were compared in the course of treatment of difference. Results Through two different methods of treatment, the heart rate, respiratory rate, PaO2, PaCO2,PaO2/FiO2were(78.88±12.03)times/min,(18.96±7.53)times/min,(140.2±18.37)mmHg(1 mmHg=0.133 kPa),(37.04±7.67)mmHg,(242.83±27.13)mmHg in the observation group,respectively,compared with(88.83±16.48)times/min,(25.46±9.51)times/min,(86.08±20.83)mmHg,(45.71±10.37)mmHg and(210.71±36.34)mmHg in the control group,which had significant differences(t=-3.922-3.415,P<0.05). The ICU stay time in the observation group was( 68.71 ± 32.38) h, respectively, which was much shorter than that in the contorl group(107.67±66.15) h, the difference was statistically significant (t=2.416, P<0.05). The occurrence rates of NPPV and the positive rates of CAM-ICU were16.7%(4/24),4.2%(1/24)in the observation group,respectively,compared with 45.8%(11/24),33.3%(8/24)in the control group,which had significant differences(x2=4.752,4.923,P<0.05). Conclusions HFNC is a new and effective way of oxygen therapy that can better improve circulation oxygenation,reduce PaCO2,reduce the rate of line of NPPV and CAM-positive rate in the ICU,and can shorten the patient's ICU stay time in the treatment of lung cancer patients with postoperative respiratory failure.
