The effect of in-bed cycling combined with high flow nasal cannula treatment on arterial oxygen and respiratory dynamics in patients with severe respiratory failure: A retrospective study.

Objective: To assess the effects of in-bed cycling (IBC) combined with high flow nasal cannula (HFNC) on arterial oxygen and respiratory dynamics in patients with severe respiratory failure (RF).

Methods: We retrospectively collected clinical data of 103 patients with severe RF, admitted to the intensive care unit (ICU) of The Second Affiliated Hospital of Harbin Medical University from March 2021 to March 2023. Among them, 50 patients had HFNC alone (control group), and 53 patients did IBC in addition to HFNC (observation group). We compared arterial oxygen index, lung function, respiratory dynamics, and clinical efficacy between the two groups.

Results: There was no significant difference in the basic data between the two groups (P>0.05). After the treatment, the improvement of the partial pressure of oxygen (PaO₂), PaO₂/fraction of inspired oxygen (FiO₂), arterial oxygen saturation (SaO₂), and oxygen delivery (DO₂) in the observation group was significantly better than that in the control group (P<0.05). After the treatment, the improvement of lung function in the observation group was better than that in the control group (P<0.05). After the treatment, the end expiratory pulmonary pressure (P_tp-ee) and driving pressure (△P_tp) levels in the observation group were significantly higher, and the duration of ICU hospitalization and the incidence of ICU-acquired weakness(ICU-AW) were significantly lower than those in the control group (P<0.05).

Conclusions: IBC combined with HFNC can significantly improve arterial oxygen levels, lung function, and respiratory dynamics in patients with severe RF. IBC in combination with HFNC is associated with shorter stay time in the ICU, reduced of ICU-acquired weakness, and better physical recovery of patients.