scholarly journals Modified high-flow nasal cannula oxygen therapy versus conventional oxygen therapy in patients undergoing bronchoscopy: a randomized clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rui Wang ◽  
Hai-Chao Li ◽  
Xu-Yan Li ◽  
Xiao Tang ◽  
Hui-Wen Chu ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Oxygen Therapy ◽  
Therapy Group ◽  
Controlled Trial ◽  
Arterial Oxygen Saturation ◽  
High Flow ◽  
Nasal Cannula ◽  
Arterial Oxygen ◽  
High Flow Nasal Cannula ◽  
Single Moment

Abstract Background Hypoxemia frequently occurs during bronchoscopy. High-flow nasal cannula (HFNC) oxygen therapy may be a feasible alternative to prevent the deterioration of gas exchange during bronchoscopy. With the convenience of clinical use in mind, we modified an HFNC using a single cannula. This clinical trial was designed to test the hypothesis that a modified HFNC would decrease the proportion of patients with a single moment of peripheral arterial oxygen saturation (SpO2) < 90% during bronchoscopy. Methods In this single-center, prospective randomized controlled trial, hospitalized patients in the respiratory department in need of diagnostic bronchoscopy were randomly assigned to a modified HFNC oxygen therapy group or a conventional oxygen therapy (COT) group. The primary outcome was the proportion of patients with a single moment of SpO2 < 90% during bronchoscopy. Results Eight hundred and twelve patients were randomized to the modified HFNC (n = 406) or COT (n = 406) group. Twenty-four patients were unable to cooperate or comply with bronchoscopy. Thus, 788 patients were included in the analysis. The proportion of patients with a single moment of SpO2 < 90% during bronchoscopy in the modified HFNC group was significantly lower than that in the COT group (12.5% vs. 28.8%, p < 0.001). There were no significant differences in the fraction of inspired oxygen between the two groups. The lowest SpO2 during bronchoscopy and 5 min after bronchoscopy in the modified HFNC group was significantly higher than that in the COT group. Multivariate analysis showed that a baseline forced vital capacity (FVC) < 2.7 L (OR, 0.276; 95% CI, 0.083–0.919, p = 0.036) and a volume of fluid instilled > 60 ml (OR, 1.034; 95% CI, 1.002–1.067, p = 0.036) were independent risk factors for hypoxemia during bronchoscopy in the modified HFNC group. Conclusions A modified HFNC could decrease the proportion of patients with a single moment of SpO2 < 90% during bronchoscopy. A lower baseline FVC and large-volume bronchoalveolar lavage may predict desaturation during bronchoscopy when using a modified HFNC. Trial registration ClinicalTrials. Gov: NCT02606188. Registered 17 November 2015.

Comparison of high-flow nasal cannula and conventional oxygen therapy following extubation after pediatric cardiac surgery: a retrospective study

2021 ◽  
Author(s):  
Ömer Faruk Şavluk ◽  
Abdullah Arif Yılmaz ◽  
Yasemin Yavuz ◽  
Fatma Ukil Işıldak ◽  
Babürhan Özbek ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Heart Disease ◽  
Retrospective Study ◽  
Oxygen Therapy ◽  
Therapy Group ◽  
High Flow ◽  
Nasal Cannula ◽  
Pediatric Cardiac Surgery ◽  
High Flow Nasal Cannula ◽  
Group I

Objectives: Infants and children with congenital heart disease may develop respiratory failure in association with cardiac surgery or as a result of heart disease. In fact, the postextubation period in this group of patients can be complex and the use of continuous positive airway pressure or non-invasive ventilation may be necessary if conventional oxygen therapy is not sufficient. The aim of our study was to compare efficiency and outcomes of high-flow nasal cannula or conventional oxygen therapy post-extubation after pediatric cardiac surgery . Patients and Methods: A single centre retrospective study was conducted between January and december 2020 in our 12 beds pediatric cardiac intensive care unit. Patients were divided into two groups. In one group 45 patients (Group I), those who received high-flow nasal cannula after extubation, and in the other group 45 patients (Group II), those who received oxygen therapy with a mask after extubation. The aim of the study was to evaluate the relative efficacy of high flow nasal cannula and conventional oxygen therapy on PaCO2 ,PaO2 and PaO2/FiO2. Results: PaO2 values at 1, 6, 12, 24 and 48 h post-extubation were significantly higher in high-flow nasal cannula group (p<0,05). PaCO2 values were significantly lower in the high-flow nasal cannula group at 1, 6, 12, 24 and 48 h post-extubation (p=0,01). PaO2/FiO2 values in high-flow nasal cannula group at all-time points post-extubation were significantly higher than in conventional oxygen therapy group (p=0,01). Conclusion: High-flow nasal cannula is useful in decreasing PaCO2 and improving PaO2 in children following extubation after cardiac surgery. In addition, the simplicity of and tolerability to high-flow nasal cannula is also important. Although more expensive, the use of high-flow nasal cannula can be considered as a safe and effective alternative to conventional oxygen therapy following pediatric cardiac surgery.

scholarly journals Benefits of High-Flow Nasal Cannula Therapy for Acute Pulmonary Edema in Patients with Heart Failure in the Emergency Department: A Prospective Multi-Center Randomized Controlled Trial

2020 ◽  
Vol 9 (6) ◽  
pp. 1937 ◽  
Author(s):  
Dong Ryul Ko ◽  
Jinho Beom ◽  
Hye Sun Lee ◽  
Je Sung You ◽  
Hyun Soo Chung ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Pulmonary Edema ◽  
Oxygen Therapy ◽  
Controlled Trial ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Arterial Blood Gas ◽  
Arterial Blood

Heart failure patients with pulmonary edema presenting to the emergency department (ED) require an effective approach to deliver sufficient oxygen and reduce the rate of intubation and mechanical ventilation in the ED; conventional oxygen therapy has proven ineffective in delivering enough oxygen to the tissues. We aimed to identify whether high-flow nasal cannula (HFNC) therapy over time improved the respiratory rate (RR), lactate clearance, and certain arterial blood gas (ABG) parameters, in comparison with conventional oxygen therapy, in patients with cardiogenic pulmonary edema. This prospective, multi-institutional, and interventional study (clinical trial, reference KCT0004578) conducted between 2016 and 2019 included adult patients diagnosed with heart failure within the previous year and pulmonary edema confirmed at admission. Patients were randomly assigned to the conventional or HFNC group and treated with the goal of maintaining oxygen saturation (SpO2) ≥ 93. We obtained RR, SpO2, lactate levels, and ABG parameters at baseline and 30 and 60 min after randomization. All parameters showed greater improvement with HFNC therapy than with conventional therapy. Significant changes in ABG parameters were achieved within 30 min. HFNC therapy could therefore be considered as initial oxygen therapy. Physicians may consider advanced ventilation if there is no significant improvement in ABG parameters within 30 min of HFNC therapy.

scholarly journals Research Trends on High-Flow Nasal Cannula Oxygen Therapy: A Bibliometric Analysis from 2000 to 2019

2020 ◽  
Author(s):  
Siyi Qi ◽  
Xiao Zhang ◽  
Sifan Chen ◽  
Chengzhun Luo ◽  
Wanbing Dai ◽  
...  
Keyword(s):  
Bibliometric Analysis ◽  
Oxygen Therapy ◽  
Hot Spot ◽  
Controlled Trial ◽  
The United States ◽  
High Flow ◽  
Nasal Cannula ◽  
Annual Number ◽  
High Flow Nasal Cannula ◽  
The Past

Abstract Purpose: High-flow nasal cannula oxygen therapy (HFNC) has been increasingly reported over the past decades. Therefore, this study aimed to analyze the evolution of HFNC research and qualitatively and quantitatively evaluate publications. Methods: Publications between 2000 and 2019 were retrieved from the Web of Science Core Collection on August 17, 2020, according to a search strategy. Different kinds of software, CiteSpace and VOSviewer, and an online bibliometric analysis platform were used to identify top authors, journals, institutions, countries, keywords, co-cited articles, and trends. Results: Finally, 835 publications were identified, and the annual number of publications showed an increasing trend. Of these, 273 journals published articles related to HFNC. The United States and the University of Melbourne were the leading country and institution for publications, respectively. Co-cited reference analysis revealed top landmark articles. High-flow nasal cannula, bronchiolitis, hypercapnia, newborn, and immunosuppression are some of the high-frequency keywords in the co-occurrence cluster and co-cited reference cluster analyses, indicating that the clinical application of oxygen therapy remains a hot spot. Burst detection analysis of top keywords showed that randomized controlled trial, viral bronchiolitis, and immunocompromised patient were the new research foci.Conclusions: Bronchopulmonary dysplasia, infant, premature infant, respiratory distress syndrome, critical care patient, preoxygenation, extubation failure, and acute lung injury are the research foci of HFNC over the past 20 years and have emerged as a basis for transformation from infancy to adulthood and from a single disease to diverse diseases.

scholarly journals The Value of High-flow Nasal Cannula Oxygen Therapy in Treating Patients With Severe Novel Coronavirus Pneumonia

2020 ◽  
Author(s):  
Xiao-bao Teng ◽  
Ya Shen ◽  
Ming-feng Han ◽  
Gang Yang ◽  
Lei Zha ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Oxygen Therapy ◽  
Therapy Group ◽  
Oxygenation Index ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Early Application ◽  
Wbc Count ◽  
Novel Coronavirus

Abstract Objective This study aimed to investigate the value of high-flow nasal cannula (HNFC) oxygen therapy in treating patients with severe novel coronavirus pneumonia (COVID-19). Methods The clinical data of 22 patients with severe COVID-19 were collected. The heart rate (HR), respiratory rate (RR) and oxygenation index (PO2/FiO2) at 0, 6, 24 and 72 hours after treatment were compared between the HFNC oxygen therapy group and the conventional oxygen therapy (COT) group. In addition, the white blood cell (WBC) count, lymphocyte (L) count, C-reactive protein (CRP) and procalcitonin (PCT) were compared before and at 72 hours after oxygen therapy treatment. Results Of the included patients, 12 were assigned to the HFNC oxygen therapy group and 10 were assigned to the COT group. The differences in HR, RR, PaO2/FiO2, WBC, L, CRP and PCT at 0 hours between the two groups were not statistically significant. At 6 hours after treatment with the two oxygen therapies, HR, RR and PaO2/FiO2 were better in the HFNC oxygen therapy group than in the COT group (p < 0.05), while at 24 and 72 hours after treatment with the two oxygen therapies, PaO2/FiO2 was better in the HFNC oxygen therapy group than in the COT group (p < 0.05), but the differences in HR and RR were not statistically significant. At 72 hours after treatment, L and CRP had significantly improved in the HFNC oxygen therapy group compared with the COT group, but the differences in WBC and PCT were not statistically significant. The length of stay in the intensive care unit (ICU) and the total length of hospitalization were shorter in the HFNC oxygen therapy group than in the COT group, and the differences between the two groups were statistically significant. Conclusion Compared with COT, early application of HFNC oxygen therapy in patients with severe COVID-19 can significantly improve oxygenation and RR, and HFNC oxygen therapy can improve the infection indexes of patients and reduce the length of stay in the ICU of patients. Therefore, it has high clinical application value.

scholarly journals High-flow nasal cannula for reducing hypoxemic events in patients undergoing bronchoscopy: A systematic review and meta-analysis of randomized trials

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260716
Author(s):  
Chien-Ling Su ◽  
Ling-Ling Chiang ◽  
Ka-Wai Tam ◽  
Tzu-Tao Chen ◽  
Ming-Chi Hu
Keyword(s):  
Systematic Review ◽  
Partial Pressure ◽  
Oxygen Therapy ◽  
Therapy Group ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
High Flow ◽  
Nasal Cannula ◽  
Cochrane Library ◽  
High Flow Nasal Cannula

Background Patients undergoing bronchoscopic procedures may develop hypoxemia and severe complications. High-flow nasal cannula (HFNC) may prevent hypoxemic events during bronchoscopy. We conducted a systematic review of randomized controlled trials (RCTs) to evaluate the effectiveness of HFNC in these patients. Methods We conducted a search in PubMed, Embase, and the Cochrane Library for RCTs published before November 2021. Individual effect sizes were standardized, and a meta-analysis was performed to calculate the pooled effect size using random-effects models. The primary outcome was the incidence of hypoxemic events (oxygen saturation [SpO2] < 90%) during bronchoscopy. Secondary outcomes included the incidence of interrupted bronchoscopy due to desaturation, lowest SpO2 during bronchoscopy, partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), end-tidal CO2 (EtCO2) at the end of bronchoscopy, and the incidence of intubation after the procedure. Results Five trials involving 257 patients were reviewed. The incidence of hypoxemic events was lower in the HFNC group than in the conventional oxygen therapy group (risk ratio, 0.25; 95% confidence interval [CI], 0.14–0.42). The lowest SpO2 during the procedure was significantly higher in the HFNC group than in the conventional oxygen therapy group (weighted mean difference [WMD], 7.12; 95% CI, 5.39–8.84). PaO2 at the end of the procedure was significantly higher in the HFNC group than in the conventional oxygen therapy group (WMD, 20.36; 95% CI, 0.30–40.42). The incidence of interrupted bronchoscopy due to desaturation, PaCO2 and EtCO2 at the end of the procedure, and the incidence of intubation after the procedure were not significantly different between groups. Conclusions HFNC may reduce the incidence of hypoxemic events and improve oxygenation in patients undergoing bronchoscopy.

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