Nasal high–flow oxygen therapy in patients with hypoxic respiratory failure: effect on functional and subjective respiratory parameters compared to conventional oxygen therapy and non-invasive ventilation (NIV)

BMC Anesthesiology

Norbert Schwabbauer³  Björn Berg³  Gunnar Blumenstock¹  Michael Haap³  Jürgen Hetzel²  Reimer Riessen³ 

[1] Department of Clinical Epidemiology and Applied Biometry, University of Tübingen, Tübingen, Germany

[2] Department of Internal Medicine, Division of Pulmonary Medicine, University of Tübingen, Tübingen, Germany

[3] Department of Internal Medicine, Medical Intensive Care Unit, University of Tübingen, Otfried-Müller-Str, 10, Tübingen 72076, Germany

关键词: Venturi mask;    Non-invasive ventilation;    High-flow nasal cannula;    Oxygen;    Respiratory failure;   

Others  :  1084527
DOI  :  10.1186/1471-2253-14-66

 received in 2013-12-22, accepted in 2014-07-25,  发布年份 2014

【 摘 要 】

Background

Aim of the study was to compare the short-term effects of oxygen therapy via a high-flow nasal cannula (HFNC) on functional and subjective respiratory parameters in patients with acute hypoxic respiratory failure in comparison to non-invasive ventilation (NIV) and standard treatment via a Venturi mask.

Methods

Fourteen patients with acute hypoxic respiratory failure were treated with HFNC (FiO₂ 0.6, gas flow 55 l/min), NIV (FiO₂ 0.6, PEEP 5 cm H₂O Hg, tidal volume 6–8 ml/kg ideal body weight,) and Venturi mask (FiO₂ 0.6, oxygen flow 15 l/min,) in a randomized order for 30 min each. Data collection included objective respiratory and circulatory parameters as well as a subjective rating of dyspnea and discomfort by the patients on a 10-point scale. In a final interview, all three methods were comparatively evaluated by each patient using a scale from 1 (=very good) to 6 (=failed) and the patients were asked to choose one method for further treatment.

Results

PaO₂ was highest under NIV (129 ± 38 mmHg) compared to HFNC (101 ± 34 mmHg, p <0.01 vs. NIV) and VM (85 ± 21 mmHg, p <0.001 vs. NIV, p <0.01 vs. HFNC, ANOVA). All other functional parameters showed no relevant differences. In contrast, dyspnea was significantly better using a HFNC (2.9 ± 2.1, 10-point Borg scale) compared to NIV (5.0 ± 3.3, p <0.05), whereas dyspnea rating under HFNC and VM (3.3 ± 2.3) was not significantly different. A similar pattern was found when patients rated their overall discomfort on the 10 point scale: HFNC 2.7 ± 1.8, VM 3.1 ± 2.8 (ns vs. HFNC), NIV 5.4 ± 3.1 (p <0.05 vs. HFNC). In the final evaluation patients gave the best ratings to HFNC 2.3 ± 1.4, followed by VM 3.2 ± 1.7 (ns vs. HFNC) and NIV 4.5 ± 1.7 (p <0.01 vs. HFNC and p <0.05 vs. VM). For further treatment 10 patients chose HFNC, three VM and one NIV.

Conclusions

In hypoxic respiratory failure HFNC offers a good balance between oxygenation and comfort compared to NIV and Venturi mask and seems to be well tolerated by patients.

Trial registration

German clinical trials register: DRKS00005132.

【 授权许可】

   
2014 Schwabbauer et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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