PURPOSE: High-flow oxygen through a nasal cannula may offer an alternative therapy to patients with respiratory failure. However, a recent study has shown that the success rate of high-flow oxygen through a nasal cannula was only 62%, and the mortality rate for patients who require intubation after failure of high-flow oxygen through a nasal cannula was as high as 32.5%. The aim of this study is to determine the parameters, specifically for emergency department presentation, associated with high-flow oxygen through a nasal cannula failure. METHODS: A retrospective cohort study was performed in respiratory patients who were admitted between June 2015 and January 2016 at a single university hospital. All patients who were treated with high-flow oxygen through a nasal cannula were included. The exclusion criteria for high-flow oxygen via nasal cannulation were as follows: Hemodynamic instability, hypercapnic coma, inefficient clearance of secretions, and cardiac arrest. Univariable regression analysis was used and, if the p-value was less than 0.10, analyses were entered into a multivariable logistic regression analysis model. RESULTS: Sixty-two patients were enrolled in our study. High-flow oxygen through a nasal cannula was successful in 33 patients, and 29 required intubation. Older age (over 65 years), Glasgow Coma Scale Score of less than 15, and respiratory rate of more than 30/min were significantly associated with the failure of high-flow oxygen through a nasal cannula according to multivariable analysis (p-value<0.05). CONCLUSION: Older age, low Glasgow Coma Scale Score, and respiratory rate of more than 30/min are factors associated with the failure of high-flow oxygen through a nasal cannula.
Catheterization ; Catheters* ; Cohort Studies ; Coma ; Emergencies* ; Emergency Service, Hospital* ; Glasgow Coma Scale ; Heart Arrest ; Hemodynamics ; Humans ; Intubation ; Logistic Models ; Mortality ; Oxygen* ; Respiratory Insufficiency* ; Respiratory Rate ; Retrospective Studies

The purpose of this retrospective study was to estimate the pretreatment characteristics of growing patients with Class II malocclusion, who had been treated with maxillary second molar extractions. The sample comprised of 51 subjects; 18 subjects were classified into the molar extraction group, and 33 subjects were treated without extraction and classified into the nonextraction group. Pretreatment lateral cephalograms were calculated and analyzed by independent t-test and stepwise discriminant analysis. In measurements for skeletal pattern, no anteroposterior measurements and proportions of various vertical dimensions were significantly different, and only some measurements such as AB-MP (degree), Na-Me (mm), AVD (mm) were significantly different between the two treatment groups (p < 0.05). In measurements for dentoalveolar pattern, some measurements, which were related to the position and angulation of the upper and lower permanent first molars, and the angulation of the upper third molars, were significantly different between the two treatment groups. In particular, the maxillary second molar extraction group exhibited more mesial angulation of maxillary first molar to the occlusal plane.
Adolescent* ; Dental Occlusion ; Discriminant Analysis ; Humans ; Malocclusion* ; Molar* ; Molar, Third ; Retrospective Studies ; Vertical Dimension