Nasal High-Flow versus Venturi Mask Oxygen Therapy after Extubation
Nasal High-Flow versus Venturi Mask Oxygen Therapy after Extubation
复制标题
DOI：
10.1164/rccm.201402-0364oc
复制
发表时间：
2014-08-01
影响因子：
24.7
通讯作者：
Antonelli, Massimo
中科院分区：
文献类型：
--
作者：
Maggiore, Salvatore Maurizio;Idone, Francesco Antonio;Antonelli, Massimo
理由：氧气通常在拔管后给药。虽然有几种设备是可用的，关于他们的临床efficacy的数据是arrived.Objectives：比较的文丘里面罩和鼻高流量（NHF）治疗拔管后的Pa-O2/FIO 2SET比的影响。次要终点是评估对患者的不适，不良事件和临床outcomes.Methods的影响：随机，对照，开放标签试验105例Pa-O2/FIO 2比值小于或等于300立即拔管前。Venturi面罩（n = 52）或NHF（n = 53）应用48小时postestubation.Measurements和主要结果：Pa-O2/FIO 2SET，由接口和气道干燥症状（10点数字评级量表），接口位移，氧饱和度下降，需要呼吸机支持，并重新插管引起的患者不适进行了评估拔管后48小时。从第24小时开始，NHF组的Pa-O2/FIO 2SET较高（24小时时为287 +/- 74 vs. 247 +/- 81; p = 0.03）。NHF组与界面和气道干燥相关的不适感更好（24 h时分别为2.6 +/- 2.2 vs. 5.1 +/- 3.3，P = 0.006; 24 h时分别为2.2 +/- 1.8 vs. 3.7 +/- 2.4，P = 0.002）。界面移位的患者较少（32% vs. 56%; P = 0.01），氧饱和度下降（40% vs. 75%; P < 0.001），需要重新插管（4% vs. 21%; P = 0.01），或任何形式的呼吸机支持结论：与文丘里面罩相比，NHF组在拔管后相同的FIO 2下氧合效果更好。使用NHF与更好的舒适度、更少的去饱和和界面位移以及更低的重新插管率相关。
Rationale: Oxygen is commonly administered after extubation. Although several devices are available, data about their clinical efficacy are scarce.Objectives: To compare the effects of the Venturi mask and the nasal high-flow (NHF) therapy on Pa-O2/FIO2SET ratio after extubation. Secondary endpoints were to assess effects on patient discomfort, adverse events, and clinical outcomes.Methods: Randomized, controlled, open-label trial on 105 patients with a Pa-O2/FIO2 ratio less than or equal to 300 immediately before extubation. The Venturi mask (n = 52) or NHF (n = 53) were applied for 48 hours postextubation.Measurements and Main Results: Pa-O2/FIO2SET, patient discomfort caused by the interface and by symptoms of airways dryness (on a 10-point numerical rating scale), interface displacements, oxygen desaturations, need for ventilator support, and reintubation were assessed up to 48 hours after extubation. From the 24th hour, Pa-O2/FIO2SET was higher with the NHF (287 +/- 74 vs. 247 +/- 81 at 24 h; p = 0.03). Discomfort related both to the interface and to airways dryness was better with NHF (respectively, 2.6 +/- 2.2 vs. 5.1 +/- 3.3 at 24 h, P = 0.006; 2.2 +/- 1.8 vs. 3.7 +/- 2.4 at 24 h, P = 0002). Fewer patients had interface displacements (32% vs. 56%; P = 0.01), oxygen desaturations (40% vs. 75%; P < 0.001), required reintubation (4% vs. 21%; P = 0.01), or any form of ventilator support (7% vs. 35%; P < 0.001) in the NHF group.Conclusions: Compared with the Venturi mask, NHF results in better oxygenation for the same set FIO2 after extubation. Use of NHF is associated with better comfort, fewer desaturations and interface displacements, and a lower reintubation rate.