High-Flow Oxygen Therapy After Noninvasive Ventilation Interruption in Patients Recovering From Hypercapnic Acute Respiratory Failure: A Physiological Crossover Trial
High-Flow Oxygen Therapy After Noninvasive Ventilation Interruption in Patients Recovering From Hypercapnic Acute Respiratory Failure: A Physiological Crossover Trial
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DOI：
10.1097/ccm.0000000000003740
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发表时间：
2019-06-01
影响因子：
8.8
通讯作者：
Navalesi, Paolo
中科院分区：
文献类型：
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作者：
Longhini, Federico;Pisani, Lara;Navalesi, Paolo
目的：评估无创通气中断时高流量氧疗和标准氧疗期间的气体交换、膈肌功能、呼吸频率和患者舒适度。设计：随机交叉生理学研究。设置：两个ICU。患者：30例慢性阻塞性肺疾病高碳酸血症急性呼吸衰竭患者接受无创通气超过24小时。干预措施：所有患者均接受了5次30分钟的试验，第一次、第三次和第五次试验采用无创通气，而第二次和第四次试验随机采用标准氧气和高流量氧气治疗。测量和主要结果：在每次试验结束时通过超声评估确定膈肌位移和增厚分数。还评估了动脉血气、呼吸频率和患者舒适度。Paco（2）（p = 0.153）和pH（p = 0.114）在试验中没有差异，而Pao（2）在无创通气中高于两种标准氧（p
Objectives: Assessing gas exchange, diaphragm function, respiratory rate, and patient comfort during high-flow oxygen therapy and standard oxygen at the time of noninvasive ventilation discontinuation. Design: Randomized crossover physiologic study. Setting: Two ICUs. Patients: Thirty chronic obstructive pulmonary disease patients with hypercapnic acute respiratory failure receiving noninvasive ventilation greater than 24 hours. Interventions: All patients underwent five 30-minute trials, the first, third, and fifth trial in noninvasive ventilation, whereas the second and fourth were randomly conducted with either standard oxygen and high-flow oxygen therapy. Measurements and Main Results: Diaphragm displacement and thickening fraction were determined by sonographic evaluation at the end of each trial. Arterial blood gases, respiratory rate, and patient comfort were also assessed. Paco(2) (p = 0.153) and pH (p = 0.114) were not different among trials, while Pao(2) was greater in noninvasive ventilation than with both standard oxygen (p