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Comparison of outcomes of high-flow nasal cannula and noninvasive positive-pressure ventilation in patients with hypoxemia and various APACHE II scores after extubation.
Ther Adv Respir Dis. 2021 Jan-Dec; 15:17534666211004235.TA

Abstract

AIMS

The study aimed to compare and analyze the outcomes of high-flow nasal cannula (HFNC) and noninvasive positive-pressure ventilation (NPPV) in the treatment of patients with acute hypoxemic respiratory failure (AHRF) who had extubation after weaning from mechanical ventilation.

METHODS

A total 120 patients with AHRF were enrolled into this study. These patients underwent tracheal intubation and mechanical ventilation. They were organized into two groups according to the score of Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II); group A: APACHE II score <12; group B: 12⩽ APACHE II score <24. Group A had 72 patients and patients given HFNC were randomly assigned to subgroup I while patients given NPPV were assigned to subgroup II (36 patients in each subgroup). Group B had 48 patients and patients given HFNC were randomly assigned to subgroup I while patients given NPPV were assigned to subgroup II (24 patients in each subgroup). General information, respiratory parameters, endpoint event, and comorbidities of adverse effect were compared and analyzed between the two subgroups.

RESULTS

The incidence of abdominal distension was significantly higher in patients treated with NPPV than in those treated with HFNC in group A (19.44% versus 0, p = 0.005) and group B (25% versus 0, p = 0.009). There was no significant difference between the HFNC- and NPPV-treated patients in blood pH, oxygenation index, partial pressure of carbon dioxide, respiratory rate, and blood lactic acid concentration in either group (p > 0.05). Occurrence rate of re-intubation within 72 h of extubation was slightly, but not significantly, higher in NPPV-treated patients (p > 0.05).

CONCLUSION

There was no significant difference between HFNC and NPPV in preventing respiratory failure in patients with AHRF with an APACHE II score <24 after extubation. However, HFNC was superior to NPPV with less incidence of abdominal distension.The reviews of this paper are available via the supplemental material section.

Authors+Show Affiliations

Department of Internal Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China.Department of Internal Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, No.169 East Lake Road, Wuchang District, Wuhan, Hubei, 430071, China. Medical Research Institute of Wuhan University, Wuhan, China.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33781130

Citation

Shang, Xiaoke, and Yanggan Wang. "Comparison of Outcomes of High-flow Nasal Cannula and Noninvasive Positive-pressure Ventilation in Patients With Hypoxemia and Various APACHE II Scores After Extubation." Therapeutic Advances in Respiratory Disease, vol. 15, 2021, p. 17534666211004235.
Shang X, Wang Y. Comparison of outcomes of high-flow nasal cannula and noninvasive positive-pressure ventilation in patients with hypoxemia and various APACHE II scores after extubation. Ther Adv Respir Dis. 2021;15:17534666211004235.
Shang, X., & Wang, Y. (2021). Comparison of outcomes of high-flow nasal cannula and noninvasive positive-pressure ventilation in patients with hypoxemia and various APACHE II scores after extubation. Therapeutic Advances in Respiratory Disease, 15, 17534666211004235. https://doi.org/10.1177/17534666211004235
Shang X, Wang Y. Comparison of Outcomes of High-flow Nasal Cannula and Noninvasive Positive-pressure Ventilation in Patients With Hypoxemia and Various APACHE II Scores After Extubation. Ther Adv Respir Dis. 2021 Jan-Dec;15:17534666211004235. PubMed PMID: 33781130.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of outcomes of high-flow nasal cannula and noninvasive positive-pressure ventilation in patients with hypoxemia and various APACHE II scores after extubation. AU - Shang,Xiaoke, AU - Wang,Yanggan, PY - 2021/3/30/entrez PY - 2021/3/31/pubmed PY - 2021/3/31/medline KW - Acute Physiologic Assessment and Chronic Health Evaluation II KW - acute hypoxemic respiratory failure KW - high-flow nasal cannula KW - noninvasive positive-pressure ventilation SP - 17534666211004235 EP - 17534666211004235 JF - Therapeutic advances in respiratory disease JO - Ther Adv Respir Dis VL - 15 N2 - AIMS: The study aimed to compare and analyze the outcomes of high-flow nasal cannula (HFNC) and noninvasive positive-pressure ventilation (NPPV) in the treatment of patients with acute hypoxemic respiratory failure (AHRF) who had extubation after weaning from mechanical ventilation. METHODS: A total 120 patients with AHRF were enrolled into this study. These patients underwent tracheal intubation and mechanical ventilation. They were organized into two groups according to the score of Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II); group A: APACHE II score <12; group B: 12⩽ APACHE II score <24. Group A had 72 patients and patients given HFNC were randomly assigned to subgroup I while patients given NPPV were assigned to subgroup II (36 patients in each subgroup). Group B had 48 patients and patients given HFNC were randomly assigned to subgroup I while patients given NPPV were assigned to subgroup II (24 patients in each subgroup). General information, respiratory parameters, endpoint event, and comorbidities of adverse effect were compared and analyzed between the two subgroups. RESULTS: The incidence of abdominal distension was significantly higher in patients treated with NPPV than in those treated with HFNC in group A (19.44% versus 0, p = 0.005) and group B (25% versus 0, p = 0.009). There was no significant difference between the HFNC- and NPPV-treated patients in blood pH, oxygenation index, partial pressure of carbon dioxide, respiratory rate, and blood lactic acid concentration in either group (p > 0.05). Occurrence rate of re-intubation within 72 h of extubation was slightly, but not significantly, higher in NPPV-treated patients (p > 0.05). CONCLUSION: There was no significant difference between HFNC and NPPV in preventing respiratory failure in patients with AHRF with an APACHE II score <24 after extubation. However, HFNC was superior to NPPV with less incidence of abdominal distension.The reviews of this paper are available via the supplemental material section. SN - 1753-4666 UR - https://www.unboundmedicine.com/medline/citation/33781130/Comparison_of_outcomes_of_high_flow_nasal_cannula_and_noninvasive_positive_pressure_ventilation_in_patients_with_hypoxemia_and_various_APACHE_II_scores_after_extubation_ L2 - https://journals.sagepub.com/doi/10.1177/17534666211004235?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -