Effect of high flow nasal oxygen therapy on patients with traumatic flail chest after extubation of mechanical ventilation
10.3760/cma.j.cn311847-20200206-00042
- VernacularTitle:高流量氧疗对创伤性连枷胸机械通气患者拔管后的疗效观察
- Author:
Yuanqing HUANG
1
;
Zhaofen LIN
;
Linhao MA
Author Information
1. 636000 四川省巴中，巴中市中医院重症医学科
- Publication Type:Journal Article
- Keywords:
Flail Chest;
Mechanical Ventilation;
High-flow oxygen therapy;
Ventilation associated pneumonia;
Mortality
- From:
Chinese journal of nautical medicine and hyperbaric medicine
2020;27(4):472-475
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical effects of high flow nasal cannula (HighFlow) on patients with traumatic flail chest after removing mechanical ventilation.Methods:A retrospective analysis was carried out on 80 traumatic flail chest patients with mechanical ventilation, admitted to the ICU of Department of Emergency and Critical Care Medicine of Shanghai Changzheng Hospital from October 2016 to December 2019, who were divided into the HighFlow group and the conventional oxygen therapy (COT) group. The clinical effects of high flow nasal cannula on PaO 2/FiO 2 ratio, ventilation-free days, re-intubation case number, length of stay in ICU, incidence of ventilation associated pneumonia (VAP), and ICU mortality were analyzed. Results:The time point of extubation of the HighFlow group was (4.6±2.1) d, while that of the COT group was (4.3±2.2) d ( P>0.05). At the time point of extubation, the differences of the ventilation oxygenation indexes, i. e. arterial blood gas pH, PaO 2, and PaCO 2, heart rate (HR), and mean arterial pressure (MAP), between the two groups were not statistically significant ( P>0.05). PaO 2/FiO 2 and PaCO 2 at 2 h after extubation in the HighFlow group were significantly improved as compared with in the COT group; the re-intubation rate of the HighFlow group was significantly lower than that of the COT group; the time of ventilation-free of the HighFlow group was significantly longer than that of the COT group; the length of stay in ICU of the HighFlow group was significantly shorter than that of the COT group; the incidence of VAP of the HighFlow group was obviously lower than that of the COT group; all differences were statistically significant ( P<0.05). Conclusion:For traumatic flail chest patients with mechanical ventilation, high flow oxygen therapy can help them wean from mechanical ventilation earlier and reduce the incidence of VAP, which is worthy of popularization and application in clinic.
