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find Keyword "经鼻高流量氧疗" 6 results
  • Efficacy of Humidified High Flow Nasal Cannula for Respiratory Failure after Ventilator Weaning in Post-operative Children with Congenital Heart Disease

    Objective To explore the efficacy of humidified high flow nasal cannula ( HHFNC) for respiratory failure after ventilator weaning in post-operative newborns and infants with congenital heart disease. Methods FromJanuary 2010 to August 2010, 33 newborns and infants [ ( 7. 8 ±8. 4) months, range 3 days to 36 months; weight ( 6. 6 ±3. 6) kg, range 2. 2 to 19. 6 kg] were treated with HHFNC ( 22 cases) and routine oxygen therapy ( 11 cases) for respiratory failure following ventilator weaning after operation of congenital heart disease. Symptoms, blood oxygen saturation ( SpO2 ) , partial pressure of oxygen( PaO2 ) , partial pressure of carbondioxide ( PaCO2 ) , incidence rate of re-intubation, duration of ICU, and hospital stay were assessed and compared between the HHFNC group and the routine oxygen therapy group.Results There were no statistical significance in the duration of ICU, hospital stay, duration of mechanical ventilation, or infection rate between the HHFNC group and the routine oxygen therapy group ( P gt; 0. 05) . But the incidence rate of re-intubation was lower in the HHFNC group than that in the routine oxygen therapy group. Meanwhile SpO2 and PaO2 increased and PaCO2 decreased significantly in the HHFNC group ( P lt;0. 05) . Conclusion HHFNC shows a clinical improvement rapidly and efficiently in preventing respiratory failure after ventilator weaning in post-operative newborns and infants with congenital heart disease.

    Release date:2016-09-13 04:07 Export PDF Favorites Scan
  • 经鼻高流量氧疗治疗急性呼吸衰竭的随机对照试验

    目的评价经鼻高流量氧疗治疗急性呼吸衰竭的临床效果。方法选择重症医学科收治的急性呼吸衰竭患者,用随机数字表法分为标准氧疗组、经鼻高流量氧疗组、无创通气组三组,分别给予面罩吸氧、经鼻高流量氧疗、无创正压机械通气治疗。观察患者 28 天气管插管率、90 天全因死亡率、治疗 48 h 后氧合状况。结果共纳入 116 例患者,其中经鼻高流量氧疗组 40 例,标准氧疗组 39 例,无创通气组 37 例。经鼻高流量氧疗组患者 28 天气管插管率明显低于标准氧疗组(22.5% 比 51.3%,OR=0.28,95%CI 0.10~0.73)和无创通气组(22.5% 比 48.6%,OR=0.31,95%CI 0.12~0.82);三组 90 天全因死亡率差异无统计学意义(分别为 15.0%、25.6% 和 24.3%,P=0.456)。治疗 48 h 后,高流量氧疗组 PaO2 较标准氧疗组、无创通气组显著升高(P=0.006),高流量氧疗组比标准氧疗组提高 PaO2/FiO2 更有优势(OR=4.02,95%CI 1.64~9.85),但高流量氧疗与无创通气 PaO2/FiO2 差异无统计学意义(P>0.05),三组患者 PaCO2、pH、呼吸频率差异无统计学意义(P>0.05)。结论与标准氧疗、无创通气相比,经鼻高流量氧疗能显著降低急性呼吸衰竭患者 28 天气管插管率,且有降低患者 90 天全因死亡率的趋势。经鼻高流量氧疗提高患者氧合比标准氧疗更有优势,和无创通气效果相当。

    Release date:2020-11-24 05:41 Export PDF Favorites Scan
  • Invasive high-flow oxygen therapy and invasive-noninvasive ventilation sequential strategies for chronic obstructive pulmonary disease patients with severe respiratory failure: a randomized controlled trial

    ObjectiveTo compare the therapeutic effects of invasive-high-flow oxygen therapy (HFNC) and invasive-non-invasive ventilation (NIV) sequential strategies on severe respiratory failure caused by chronic obstructive pulmonary disease (COPD), and explore the feasibility of HFNC after extubation from invasive ventilation for COPD patients with severe respiratory failure.MethodsFrom October 2017 to October 2019, COPD patients with type Ⅱ respiratory failure who received invasive ventilation were randomly assigned to a HFNC group and a NIV group at 1: 1 in intensive care unit (ICU), when pulmonary infection control window appeared after treatments. The patients in the HFNC group received HFNC, while the patients in the NIV group received NIV after extubation. The primary endpoint was treatment failure rate. The secondary endpoints were blood gas analysis and vital signs at 1 hour, 24 hours, and 48 hours after extubation, total respiratory support time after extubation, daily airway care interventions, comfort scores, and incidence of nasal and facial skin lesions, ICU length of stay, total length of stay and 28-day mortality after extubation.ResultsOne hundred and twelve patients were randomly assigned to the HFNC group and the NIV group. After secondary exclusion, 53 patients and 52 patients in the HFNC group and the NIV group were included in the analysis respectively. The treatment failure rate in the HFNC group was 22.6%, which was lower than the 28.8% in the NIV group. The risk difference of the failure rate between the two groups was –6.2% (95%CI –22.47 - 10.43, P=0.509), which was significantly lower than the non-inferior effect of 9%. Analysis of the causes of treatment failure showed that treatment intolerance in the HFNC group was significantly lower than that in the NIV group, with a risk difference of –38.4% (95%CI –62.5 - –3.6, P=0.043). One hour after extubation, the respiratory rate of both groups increased higher than the baseline level before extubation (P<0.05). 24 hours after extubation, the respiratory rate in the HFNC group decreased to the baseline level, but the respiratory rate in the NIV group was still higher than the baseline level, and the respiratory rate in the HFNC group was lower than that in the NIV group [(19.1±3.8) vs. (21.7±4.5) times per minute, P<0.05]. 48 hours after extubation, the respiratory rates in the two groups were not significantly different from their baseline levels. The average daily airway care intervention in the NIV group was 9 (5 - 12) times, which was significantly higher than the 5 (4 - 7) times in the HFNC group (P=0.006). The comfort score of the HFNC group was significantly higher than that of the NIV group (8.6±3.2 vs. 5.7±2.8, P= 0.022), while the incidence of nasal and facial skin lesions in the HFNC group was significantly lower than that in the NIV group (0 vs. 9.6%, P=0.027). There was no significant difference in dyspnea score, length of stay and 28-day mortality between the two groups.ConclusionsThe efficacy of invasive-HFNC sequential treatment on COPD with severe respiratory failure is not inferior to that of invasive-NIV sequential strategy. The two groups have similar treatment failure rates, and HFNC has better comfort and treatment tolerance.

    Release date:2021-06-30 03:41 Export PDF Favorites Scan
  • 经鼻高流量氧疗治疗慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭的临床疗效观察

    目的 探讨经鼻高流量氧疗(HFNC)治疗慢性阻塞性肺疾病(简称慢阻肺)急性加重合并Ⅱ型呼吸衰竭的临床疗效。方法 选取2017年1月至2019年3月昆山市第三人民医院收治的慢阻肺急性加重合并Ⅱ型呼吸衰竭患者的病例资料进行回顾性分析,共108例。在标准治疗的基础上根据给氧方式分成HFNC组(33例)、无创正压机械通气(NPPV)组(35例)和低流量氧疗组(40例)。观察三组患者治疗前后动脉血气指标、生命体征指标和不良反应,比较三组治疗模式临床转归的差异。结果 HFNC组和NPPV组治疗后的血气分析(PaO2、PaCO2及pH)、心率、气管插管率、生活质量评价等指标上显著优于低流量氧疗组,HFNC组和NPPV组平均住院时间均短于低流量氧疗组,HFNC组治疗后的心率、呼吸频率、腹腔胀气、颜面部压伤、鼻黏膜干燥和出血等显著优于NPPV组及低流量氧疗组,差异有显著统计学意义(P<0.05)。结论 对于治疗慢阻肺急性加重合并Ⅱ型呼吸衰竭的患者,HFNC和NPPV均有较好的临床效果。HFNC具有不良反应少、患者耐受性好等特点,在慢阻肺急性加重合并Ⅱ型呼吸衰竭治疗中值得推广应用。

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  • Meta-analysis of sequential efficacy of intranasal high-flow oxygen therapy versus non-invasive mechanical ventilation in invasive mechanical ventilation

    Objective To compare the sequential efficacy of high-flow nasal cannula oxygen therapy (HFNC) with non-invasive mechanical ventilation (NIV). Methods Randomized controlled trials comparing the efficacy of NIV sequential invasive mechanical ventilation with HFNC were included in the Chinese Journal Full-text Database, VIP Journal database, Wanfang Database, Chinese Biomedical Literature Database, PubMed, Cochrane Library and Embase. Meta-analysis was performed using RevMan5.4 software. Results A total of 2404 subjects were included in 19 studies. Meta-analysis results showed that compared with NIV, HFNC had a statistically significant difference in reducing patients' re-intubation rate in invasive mechanical ventilation sequence [relative risk (RR)=0.65, 95% confidence interval (CI) 0.50 - 0.86, Z=3.10, P=0.002]. HFNC showed statistically significant difference compared with NIV in reducing lung infection rate (RR=0.40, 95%CI 0.21 - 0.79, Z=2.67, P=0.008). HFNC was significantly different from NIV in terms of length of stay in Intensive Care Unit (ICU) (MD=–5.77, 95%CI –7.64 - –3.90, Z=6.05, P<0.00001). HFNC was significantly different from NIV in improving 24 h oxygenation index (MD=13.16, 95%CI 8.77 - 17.55, Z=5.87, P<0.00001). There was no significant difference in ICU mortality between HFNC and NIV (RR=0.70, 95%CI 0.45 - 1.08, Z=1.61, P=0.11). Conclusion Compared with NIV, sequential application of HFNC in invasive mechanical ventilation can improve the reintubation rate and pulmonary infection rate to a certain extent, reduce the length of ICU stay and improve the 24 h oxygenation index, while there is no difference in ICU mortality, which is worthy of clinical application.

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  • Clinical efficacy of sequential HFNC versus NIPPV after extubation in AECOPD patients: a meta-analysis of randomized controlled trials

    ObjectiveTo systematically evaluate the efficacy of high-flow nasal cannula oxygen therapy (HFNC) in Post-extubation acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients. MethodsThe Domestic and foreign databases were searched for all published available randomized controlled trials (RCTs) about HFNC therapy in post-extubation AECOPD patients. The experimental group was treated with HFNC, while the control group was treated with non-invasive positive pressure ventilation (NIPPV). The main outcome measurements included reintubation rate. The secondary outcomes measurements included oxygenation index after extubation, length of intensive care unit (ICU) stay, mortality, comfort score and adverse reaction rate. Meta-analysis was performed by Revman 5.3 software. ResultA total of 20 articles were enrolled. There were 1516 patients enrolled, with 754 patients in HFNC group, and 762 patients in control group. The results of Meta-analysis showed that there were no significant difference in reintubation rate [RR=1.41, 95%CI 0.97 - 2.07, P=0.08] and mortality [RR=0.91, 95%CI 0.58 - 1.44, P=0.69]. Compared with NIPPV, HFNC have advantages in 24 h oxygenation index after extubation [MD=4.66, 95%CI 0.26 - 9.05, P=0.04], length of ICU stay [High risk group: SMD –0.52, 95%CI –0.74 - –0.30; Medium and low risk group: MD –1.12, 95%CI –1.56- –0.67; P<0.00001], comfort score [MD=1.90, 95%CI 1.61 - 2.19, P<0.00001] and adverse reaction rate [RR=0.22, 95%CI 0.16 - 0.31, P<0.00001]. ConclusionsCompared with NIPPV, HFNC could improve oxygenation index after extubation, shorten the length of ICU stay, effectively improve Patient comfort, reduce the occurrence of adverse reactions and it did not increase the risk of reintubation and mortality. It is suggested that HFNC can be cautiously tried for sequential treatment of AECOPD patients after extubation, especially those who cannot tolerate NIPPV.

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