[EngO3-5] Effect of high-flow via non-rebreathing face mask compared to nasal cannula on nasopharyngeal CPAP, gas exchange and clinical outcome after extubation in surgical patients
Objectives: To compare the nasopharyngeal pressure that generates by using high-flow face mask(HFFM) compare with the high-flow nasal cannula(HFNC) and conventional oxygen therapy after extubation in surgical patients
Methods and materials: The present research conducted a randomized controlled trial in patients who admitted to surgical intensive care unit, Ramathibodi hospital and ready for extubation after spontaneous breathing trial between November 15, 2016 and October 31, 2017. The patients were randomized to HFFM, HFNC with the flow rate 50 L/min or aerosol mask with nebulizer flow 10 L/min after extubation. The nasopharyngeal pressures and gas exchange during oxygen therapy was records and analyzed. Other outcomes were dyspnea score, comfortable score, re-intubation rate, ICU lengths of stay, hospital lengths of stay and mortality rate.
Results: Sixty patients were enrolled (20 patients in each group).The gas exchange were not different between group (p > 0.05). The expiratory nasopharyngeal pressure that generate via using HFFM, HFNC, conventional oxygen therapy were 0.5, 1.8 and 0.35 cmH2O (p < 0.01),respectively. The mean nasopharyngeal pressure that generate via using HFFM, HFNC, conventional oxygen therapy were 1.2, 2.2 and 0.85 cmH2O (p < 0.01),respectively. The Inspiratory nasopharyngeal pressure that generate via using HFFM, HFNC, conventional oxygen therapy were 0.1, 1.1 and 0.03 cmH2O (p = 0.31),respectively. The dyspnea score, comfortable score, re-intubation rate, ICU lengths of stay, hospital lengths of stay and mortality rate were not difference (p > 0.05).
Conclusions: The present study showed no difference in gas exchange between study groups. HFNC can generate mean nasopharyngeal pressure and expiratory nasopharyngeal pressure superior to HFFM and conventional oxygen therapy. The dyspnea score, comfortable score, re-intubation rate, ICU lengths of stay, hospital lengths of stay and mortality rate were not different between groups.
Keywords: Surgical patients, High-flow nasal cannula, High-flow face mask, Conventional oxygen therapy, Post-extubation
Methods and materials: The present research conducted a randomized controlled trial in patients who admitted to surgical intensive care unit, Ramathibodi hospital and ready for extubation after spontaneous breathing trial between November 15, 2016 and October 31, 2017. The patients were randomized to HFFM, HFNC with the flow rate 50 L/min or aerosol mask with nebulizer flow 10 L/min after extubation. The nasopharyngeal pressures and gas exchange during oxygen therapy was records and analyzed. Other outcomes were dyspnea score, comfortable score, re-intubation rate, ICU lengths of stay, hospital lengths of stay and mortality rate.
Results: Sixty patients were enrolled (20 patients in each group).The gas exchange were not different between group (p > 0.05). The expiratory nasopharyngeal pressure that generate via using HFFM, HFNC, conventional oxygen therapy were 0.5, 1.8 and 0.35 cmH2O (p < 0.01),respectively. The mean nasopharyngeal pressure that generate via using HFFM, HFNC, conventional oxygen therapy were 1.2, 2.2 and 0.85 cmH2O (p < 0.01),respectively. The Inspiratory nasopharyngeal pressure that generate via using HFFM, HFNC, conventional oxygen therapy were 0.1, 1.1 and 0.03 cmH2O (p = 0.31),respectively. The dyspnea score, comfortable score, re-intubation rate, ICU lengths of stay, hospital lengths of stay and mortality rate were not difference (p > 0.05).
Conclusions: The present study showed no difference in gas exchange between study groups. HFNC can generate mean nasopharyngeal pressure and expiratory nasopharyngeal pressure superior to HFFM and conventional oxygen therapy. The dyspnea score, comfortable score, re-intubation rate, ICU lengths of stay, hospital lengths of stay and mortality rate were not different between groups.
Keywords: Surgical patients, High-flow nasal cannula, High-flow face mask, Conventional oxygen therapy, Post-extubation