Application of high-flow humidified oxygen therapy in patients with tracheotomy and non-mechanical ventilation
10.3760/cma.j.cn121430-20210425-00104
- VernacularTitle:高流量湿化氧疗在气管切开非机械通气患者中的应用
- Author:
Runling GUO
1
;
Zhaoqing SUN
;
Yaoyong WANG
;
Ying WANG
Author Information
1. 山西省汾阳医院呼吸与危重症医学科,山西汾阳 032200
- Keywords:
Tracheotomy high flow-oxygen therapy;
Non-mechanical ventilation;
Clinical application
- From:
Chinese Critical Care Medicine
2021;33(9):1133-1135
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the effect of tracheotomy high-flow oxygen therapy (THFO) on the clinical efficacy of non-mechanically ventilated patients undergoing a tracheotomy.Methods:Sixty adult patients with tracheotomy and non-mechanical ventilation who were diagnosed and treated from January 2019 to December 2020 in Fenyang Hospital of Shanxi Province were enrolled. According to the random number table, the patients were divided into Venturi oxygen therapy group and THFO group, 30 cases in each group. The THFO group was given oxygen therapy with THFO; the Venturi group (without mask) was given Venturi connected the MR850 base and the ventilator tube. Observe the changes of two groups at 7 AM within 5 days, including body temperature which was 1 ℃ higher than the baseline, white blood cell count (WBC) which was 2×10 9/L higher than baseline, oxygenation index (PaO 2/FiO 2) < 300 mmHg (1 mmHg = 0.133 kPa), the occurrence of lower respiratory tract infections (based on radiography), and changes in sputum indexing and sputum formation. Results:Compared with the Venturi oxygen therapy group, the body temperature increased > 1 ℃, WBC increased by 2×10 9/L, PaO 2/FiO 2 < 300 mmHg, and the proportion of lower respiratory tract infection in THFO group decreased significantly [body temperature increased > 1 ℃: 10.0% (3/30) vs. 13.3% (4/30), WBC increased by 2×10 9/L: 10.0% (3/30) vs. 30.0% (9/30), PaO 2/FiO 2 < 300 mmHg: 3.3% (1/30) vs. 10.0% (3/30), the proportion of lower respiratory tract infection: 6.7% (2/30) vs. 13.3% (4/30), all P < 0.05]. The proportion of patients with sputum scab formation and sputum viscosity of Ⅰ degree were significantly increased [sputum scab formation: 16.7% (5/30) vs. 6.7% (2/30), sputum viscosity of Ⅰ degree: 30.0% (9/30) vs. 20.0% (6/30), both P < 0.05]. Conclusion:THFO during non-mechanical ventilation of adult patients with tracheotomy can maintain a higher oxygen partial pressure and ideally control the temperature and humidity of the inhaled gas, promote the discharge of sputum with degreeⅠ andⅡ viscosity, thereby reducing the tracheotomy complications such as lower respiratory tract infections.
