Efficacy Analysis of High-flow Nasal Oxygen Therapy in Patients
Accepting Single-port Video-assisted Thoracoscopic Lobectomy.
10.3779/j.issn.1009-3419.2022.102.38
- Author:
Xuejuan ZHU
1
;
Xiaofan WANG
1
;
Xing JIN
1
;
Yonghua SANG
1
;
Wentao YANG
1
;
Yongbing CHEN
1
;
Shanzhou DUAN
1
Author Information
1. Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
- Publication Type:Randomized Controlled Trial
- Keywords:
High-flow nasal oxygen therapy;
Hypoxemia;
Lobectomy;
Noninvasive mechanical ventilation;
Video-assisted thoracic surgery
- MeSH:
Carbon Dioxide;
Humans;
Hypoxia/surgery*;
Lung Neoplasms/surgery*;
Oxygen;
Pneumonectomy/methods*;
Thoracic Surgery, Video-Assisted/methods*
- From:
Chinese Journal of Lung Cancer
2022;25(9):642-650
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Patients who underwent lobectomy resection are prone to hypoxemia, and the vast majority present with type I respiratory failure. Thus, improvement of hypoxemia is one of the most important factors to facilitate postoperative recovery of patients. In this study, the superiority-inferiority of different oxygen inhalation methods were compared with high-flow nasal oxygen therapy (HFNO), noninvasive mechanical ventilation (NIMV) and nasal oxygen breath (NOB) in patients with hypoxemia after single-port video-assisted thoracoscopic (VATS) lobectomy, and the clinical efficacy of HFNO in these patients was further investigated.
METHODS:A total of 180 patients from the Second Affiliated Hospital of Soochow University in China with hypoxemia who accepting single-port VATS lobectomy from June 2021 to March 2022 were randomly divided into three groups (n=60), which were treated with HFNO, NIMV and NOB, respectively. The results of arterial blood gas analysis, patient's comfort score and incidence of complications were observed before, 1 h, 6 h-12 h and after use. Statistical analyses were conducted using statistical program for social sciences 25.0 (SPSS 25.0), and P<0.05 was considered as statistical significance.
RESULTS:For patients with hypoxemia after accepting single-port VATS lobectomy, HFNO was no less effective than NIMV (P=0.333), and both of whom could fast increase patients' partial pressure of oxygen/fraction of inspiration O₂ (PaO₂/FiO₂) compared to NOB (P<0.001). Besides, HFNO shows a great advantage in comfort degree and stay length (P<0.001, P=0.004), and incidence of complications were slightly lower than other groups (P=0.232). But it is worthy to note that HFNO is still slightly less effective than NIMV in patients with postoperative hypoxemia accompanied by elevated partial pressure of carbon dioxide (PaCO₂).
CONCLUSIONS:For patients with hypoxemia who accepting single-port VATS lobectomy, HFNO can be used as the first choice. However, for patients with postoperative hypoxemia accompanied by elevated PaCO₂, NIMV is still recommended to improve oxygenation.
