The role of high-flow nasal cannula oxygen therapy in patients with high cervical spinal cord injury

Q4 Nursing

中华急诊医学杂志 Pub Date : 2019-08-10 DOI:10.3760/CMA.J.ISSN.1671-0282.2019.08.017

Feng-lu Yang, Chunshuang Wu, X. Cao, Ding-qian Wu, Xiao Lu

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Abstract

Objective To study the effect of high-flow nasal cannula oxygen therapy (HFNC) in reduction in re-intubation rate, length of ICU stay and improvement of respiratory function in patients with high cervical spinal cord injury. Methods Single center retrospective study was carried out in our intensive care unit from September 2016 to March 2018. Post-operative patients ready for planned extubation with high cervical spinal cord injury were included. The length of ICU stay, re-intubation rate in case of respiratory failure, respiratory rate, pulse rate, MAP, SaO2, PaO2/FiO2, and PaCO2 of patients at 6, 24 and 72 h after extubation were compared between the HFNC and conventional oxygen therapy (COT) groups. Results During the study period, 38 patients were enrolled in the study. Of them, 16 patients were assigned in the HFNC group and 22 patients in the COT group. Re-intubation rate was significantly different between the two groups (18.8% vs 27.3%, P<0.05), but the length of ICU stay had no significant difference [(15.5±3.4) days vs (16.6±5.2) days]. The respiratory rate, pulse rate, SaO2 and PaO2/FiO2 at 6 h after extubation in the HFNC group were improved markedly than those in the COT group (P<0.05); and the PaCO2 and PaO2/FiO2 at 24 and 72 h after extubation in the HFNC group had much more improvement than those in the COT group (P<0.05). Conclusions Among individuals with post-operative high cervical spinal cord injury, high-flow oxygen therapy could reduce re-intubation rate, and PaCO2 level, and improve the respiratory function, but cannot reduce the length of ICU stay. High-flow oxygen therapy may offer advantages for patients with high cervical spinal cord injury. Key words: High-flow nasal cannula; High cervical spinal cord injury; Post-operation; Extubation; retrospective study

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高流量鼻插管氧疗在高位颈脊髓损伤中的作用

目的探讨高流量鼻插管氧疗（HFNC）在降低高颈脊髓损伤患者再插管率、ICU住院时间和改善呼吸功能方面的作用。方法2016年9月至2018年3月在我院重症监护室进行单中心回顾性研究。术后准备进行计划拔管的高颈脊髓损伤患者也包括在内。比较HFNC组和常规氧疗组在拔管后6、24和72小时的ICU住院时间、呼吸衰竭时的再插管率、呼吸频率、脉搏率、MAP、SaO2、PaO2/FiO2和PaCO2。结果在研究期间，共有38名患者参与了研究。其中，HFNC组有16名患者，COT组有22名患者。两组再次插管率有显著差异（18.8%与27.3%，P<0.05），但ICU住院时间无显著差异[（15.5±3.4）天与（16.6±5.2）天]。HFNC组拔管后6h的呼吸频率、脉搏率、SaO2和PaO2/FiO2均明显优于COT组（P<0.05）；HFNC组拔管后24和72 h的PaCO2和PaO2/FiO2的改善程度明显高于COT组（P<0.05）。高流量氧气治疗可能为高颈脊髓损伤患者提供优势。关键词：高流量鼻插管；高位颈脊髓损伤；术后；拔管；回顾性研究

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来源期刊

中华急诊医学杂志 Nursing-Emergency Nursing

CiteScore

0.10

自引率

0.00%

发文量

8629

期刊介绍： Chinese Journal of Emergency Medicine is the only national journal which represents the development of emergency medicine in China. The journal is supervised by China Association of Science and Technology, sponsored by Chinese Medical Association, and co-sponsored by Zhejiang University. The journal publishes original research articles dealing with all aspects of clinical practice and research in emergency medicine. The columns include Pre-Hospital Rescue, Emergency Care, Trauma, Resuscitation, Poisoning, Disaster Medicine, Continuing Education, etc. It has a wide coverage in China, and builds up communication with Hong Kong, Macao, Taiwan and international emergency medicine circles.