Predictors of successful separation from high-flow nasal oxygen therapy in patients with acute respiratory failure: a retrospective monocenter study
Predictors of successful separation from high-flow nasal oxygen therapy in patients with acute respiratory failure: a retrospective monocenter study
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DOI：
10.1186/s13613-019-0578-8
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发表时间：
2019-09-11
影响因子：
8.1
通讯作者：
Coudroy, Remi
中科院分区：
文献类型：
--
作者：
Rodriguez, Maeva;Thille, Arnaud W.;Coudroy, Remi
高流量鼻氧疗法（HFOT）是治疗急性呼吸衰竭的一线疗法。然而，它的断奶从未被研究过，可能导致不必要的延长重症监护病房（ICU）的停留时间。本研究的目的是评估危重患者成功脱离HFOT的预测因素。我们进行了一项为期2年的回顾性单中心观察性研究，包括在ICU接受HFOT治疗急性呼吸衰竭的所有患者。排除了既往未尝试HFOT分离而死亡或插管、在HFOT分离时接受无创通气治疗或在拔管后期间接受HFOT作为预防性治疗的患者。结果在分析的190例患者中，168例（88%）在第一次尝试时成功与HFOT分离。首次尝试分离HFOT失败的患者比成功分离的患者在ICU的停留时间更长：10天（7-12）vs. 5天（4-8），p < 0.0001。吸入氧分数（FiO（2））= 9.2预测成功分离HFOT，灵敏度分别为85%和84%。结论FiO（2）= 9.2是床旁成功分离HFOT的两个预测因素。需要前瞻性多中心研究来证实这些结果。
Background High-flow nasal oxygen therapy (HFOT) is a promising first-line therapy for acute respiratory failure. However, its weaning has never been investigated and could lead to unnecessary prolonged intensive-care unit (ICU) stay. The aim of this study is to assess predictors of successful separation from HFOT in critically ill patients. We performed a retrospective monocenter observational study over a 2-year period including all patients treated with HFOT for acute respiratory failure in the ICU. Those who died or were intubated without prior HFOT separation attempt, who were treated with non-invasive ventilation at the time of HFOT separation, or who received HFOT as a preventive treatment during the post-extubation period were excluded. Results From the 190 patients analyzed, 168 (88%) were successfully separated from HFOT at the first attempt. Patients who failed separation from HFOT at the first attempt had longer ICU length of stay than those who succeeded: 10 days (7-12) vs. 5 (4-8), p < 0.0001. Fraction of inspired oxygen (FiO(2)) = 9.2 predicted successful separation from HFOT with sensitivity of 85% and 84%, respectively. Conclusions FiO(2) = 9.2 were two predictors of successful separation from HFOT at the bedside. Prospective multicenter studies are needed to confirm these results.