Impact of high-flow oxygen therapy via high velocity nasal insufflation on diaphragmatic thickening fraction in healthy subjects

Medicina intensiva Pub Date : 2024-07-23 DOI:10.1016/j.medine.2024.05.017

Gustavo Adrián Plotnikow , Facundo José Federico Bianchini , Roque Moracci , Jaime Andrés Santana Mackinlay , Federico Melgarejo , Malena Paula Loustau , Valeria Silvina Acevedo , Emanuel Di Salvo , Facundo Javier Gutierrez , Matias Madorno , Javier Mariani

{"title":"Impact of high-flow oxygen therapy via high velocity nasal insufflation on diaphragmatic thickening fraction in healthy subjects","authors":"Gustavo Adrián Plotnikow , Facundo José Federico Bianchini , Roque Moracci , Jaime Andrés Santana Mackinlay , Federico Melgarejo , Malena Paula Loustau , Valeria Silvina Acevedo , Emanuel Di Salvo , Facundo Javier Gutierrez , Matias Madorno , Javier Mariani","doi":"10.1016/j.medine.2024.05.017","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>The primary objective of this study was to evaluate the impact of high-flow nasal cannula oxygen therapy [HFNC] on the diaphragm thickening fraction.</div></div><div><h3>Design</h3><div>Prospective, descriptive, cohort study</div></div><div><h3>Setting</h3><div>The study was conducted in the Physiology and Respiratory Care Laboratory, Intensive Care Unit, Hospital Británico de Buenos Aires.</div></div><div><h3>Participants</h3><div>Thirteen healthy subjects >18 years old</div></div><div><h3>Interventions</h3><div>High-flow nasal cannula oxygen therapy</div></div><div><h3>Main variables of interest</h3><div>Demographic data (age and gender), anthropometric data (weight, height, and body mass index), and clinical and respiratory variables (Diaphragm thickening fraction [DTf], esophageal pressure swing, respiratory rate [RR], esophageal pressure-time product per minute [PTPes/min]).</div></div><div><h3>Results</h3><div>Median DTf decreased significantly as flow increased (p < 0.05). The baseline DTf measurement was 21.4 %, 18.3 % with 20 L/m, and 16.4 % with 40 L/m. We also observed a significant decrease in RR as flow increased in HFNC (p < 0.05). In the 8 subjects with recordings, the PTPes/min was 81.3 (±30.8) cmH2O/sec/min and 64.4 (±25.3) cmH<sub>2</sub>O/sec/min at baseline and 40 L/m respectively (p = 0.044).</div></div><div><h3>Conclusions</h3><div>The use of high-flow oxygen therapy through nasal cannula of HFNC in healthy subjects decreases the DTf and RR in association with increased flow. In addition, the use of 40 L/m flow may reduce the muscular work associated with respiration.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 12","pages":"Pages 686-692"},"PeriodicalIF":0.0000,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medicina intensiva","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S217357272400198X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

The primary objective of this study was to evaluate the impact of high-flow nasal cannula oxygen therapy [HFNC] on the diaphragm thickening fraction.

Design

Prospective, descriptive, cohort study

Setting

The study was conducted in the Physiology and Respiratory Care Laboratory, Intensive Care Unit, Hospital Británico de Buenos Aires.

Participants

Thirteen healthy subjects >18 years old

Interventions

High-flow nasal cannula oxygen therapy

Main variables of interest

Demographic data (age and gender), anthropometric data (weight, height, and body mass index), and clinical and respiratory variables (Diaphragm thickening fraction [DTf], esophageal pressure swing, respiratory rate [RR], esophageal pressure-time product per minute [PTPes/min]).

Results

Median DTf decreased significantly as flow increased (p < 0.05). The baseline DTf measurement was 21.4 %, 18.3 % with 20 L/m, and 16.4 % with 40 L/m. We also observed a significant decrease in RR as flow increased in HFNC (p < 0.05). In the 8 subjects with recordings, the PTPes/min was 81.3 (±30.8) cmH2O/sec/min and 64.4 (±25.3) cmH₂O/sec/min at baseline and 40 L/m respectively (p = 0.044).

Conclusions

The use of high-flow oxygen therapy through nasal cannula of HFNC in healthy subjects decreases the DTf and RR in association with increased flow. In addition, the use of 40 L/m flow may reduce the muscular work associated with respiration.

查看原文本刊更多论文

通过高速鼻腔充气进行高流量氧疗对健康受试者膈肌增厚率的影响。

研究目的本研究的主要目的是评估高流量鼻插管氧疗[HFNC]对横隔膜增厚分数的影响：前瞻性、描述性、队列研究：研究在布宜诺斯艾利斯不列颠医院重症监护室生理学和呼吸护理实验室进行：干预措施：高流量鼻插管供氧疗法主要关注变量：人口统计学数据（年龄和性别）：人口统计学数据（年龄和性别）、人体测量数据（体重、身高和体重指数）以及临床和呼吸变量（膈肌增厚分数[DTf]、食管压力摆动、呼吸频率[RR]、食管压力-时间乘积/分钟[PTPes/min]）：结果：随着流量的增加，中位 DTf 明显降低（基线和 40 L/m 时分别为 2O/sec/min (p = 0.044)）：结论：健康受试者通过 HFNC 鼻插管进行高流量氧疗时，DTf 和 RR 会随着流量的增加而降低。此外，使用 40 L/m 流量可减少与呼吸有关的肌肉工作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Medicina intensiva

自引率

0.00%

发文量