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Comparative study of high flow nasal catheter device and noninvasive positive pressure ventilation for sequential treatment in sepsis patients after weaning from mechanical ventilation in intensive care unit.
Ann Palliat Med. 2021 Jun; 10(6):6270-6278.AP

Abstract

BACKGROUND

The hypoxemia condition after mechanical ventilation (MV) weaning is not rare among sepsis patients, so we compared the efficacy in two different intervention groups: high-flow nasal cannula device group and non-invasive positive pressure ventilation (NPPV) group.

METHODS

This is a retrospective cohort study. Participants were patients with sepsis receiving high-flow nasal catheter (HFNC) device or NPPV within 24 hours after weaning from MV. The primary outcome was tracheal re-intubation within 72 hours after extubation. Secondary outcomes included: oxygenation index, complication rate, patient comfort evaluation, HFNC/NPPV treatment time, ICU length of stay (LOS), ICU mortality, and in-hospital 28-day mortality.

RESULTS

A total of 283 patients were included in the study with 167 in the HFNC group and 116 in the NPPV group. The re-intubation rates after extubation in both groups were respectively 4.2% and 5.2% without significant difference. Patients in the HFNC group experienced lower incidence of delirium, reflux aspiration, facial pressure ulcer and other complications, and higher score of patients comfort than that in the NPPV group. There was no significant difference in ICU LOS, ICU mortality and in-hospital 28-day mortality between the two groups.

CONCLUSIONS

HFNC and NPPV have similar efficacy in the sequential treatment of sepsis patients after weaning from MV. Compared with NPPV, those extubated to HFNC had lower rate of complications such as reflux aspiration and facial pressure ulcers. The patients extubation to HFNC is more comfortable (and associated with less delirium) than to NPPV.

Authors+Show Affiliations

Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.Department of Burn and Plastic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34237954

Citation

Xuan, Lizhen, et al. "Comparative Study of High Flow Nasal Catheter Device and Noninvasive Positive Pressure Ventilation for Sequential Treatment in Sepsis Patients After Weaning From Mechanical Ventilation in Intensive Care Unit." Annals of Palliative Medicine, vol. 10, no. 6, 2021, pp. 6270-6278.
Xuan L, Ma J, Tao J, et al. Comparative study of high flow nasal catheter device and noninvasive positive pressure ventilation for sequential treatment in sepsis patients after weaning from mechanical ventilation in intensive care unit. Ann Palliat Med. 2021;10(6):6270-6278.
Xuan, L., Ma, J., Tao, J., Zhu, L., Lin, S., Chen, S., Pan, S., Zhu, D., Yi, L., & Zheng, Y. (2021). Comparative study of high flow nasal catheter device and noninvasive positive pressure ventilation for sequential treatment in sepsis patients after weaning from mechanical ventilation in intensive care unit. Annals of Palliative Medicine, 10(6), 6270-6278. https://doi.org/10.21037/apm-21-8
Xuan L, et al. Comparative Study of High Flow Nasal Catheter Device and Noninvasive Positive Pressure Ventilation for Sequential Treatment in Sepsis Patients After Weaning From Mechanical Ventilation in Intensive Care Unit. Ann Palliat Med. 2021;10(6):6270-6278. PubMed PMID: 34237954.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative study of high flow nasal catheter device and noninvasive positive pressure ventilation for sequential treatment in sepsis patients after weaning from mechanical ventilation in intensive care unit. AU - Xuan,Lizhen, AU - Ma,Jiefei, AU - Tao,Jiale, AU - Zhu,Ling, AU - Lin,Shilong, AU - Chen,Song, AU - Pan,Simeng, AU - Zhu,Duming, AU - Yi,Lei, AU - Zheng,Yijun, PY - 2021/01/02/received PY - 2021/05/06/accepted PY - 2021/7/9/entrez PY - 2021/7/10/pubmed PY - 2021/7/13/medline KW - ICU KW - high-flow nasal catheter device KW - mechanical ventilation (MV) KW - non-invasive positive pressure ventilation (NPPV) KW - sepsis SP - 6270 EP - 6278 JF - Annals of palliative medicine JO - Ann Palliat Med VL - 10 IS - 6 N2 - BACKGROUND: The hypoxemia condition after mechanical ventilation (MV) weaning is not rare among sepsis patients, so we compared the efficacy in two different intervention groups: high-flow nasal cannula device group and non-invasive positive pressure ventilation (NPPV) group. METHODS: This is a retrospective cohort study. Participants were patients with sepsis receiving high-flow nasal catheter (HFNC) device or NPPV within 24 hours after weaning from MV. The primary outcome was tracheal re-intubation within 72 hours after extubation. Secondary outcomes included: oxygenation index, complication rate, patient comfort evaluation, HFNC/NPPV treatment time, ICU length of stay (LOS), ICU mortality, and in-hospital 28-day mortality. RESULTS: A total of 283 patients were included in the study with 167 in the HFNC group and 116 in the NPPV group. The re-intubation rates after extubation in both groups were respectively 4.2% and 5.2% without significant difference. Patients in the HFNC group experienced lower incidence of delirium, reflux aspiration, facial pressure ulcer and other complications, and higher score of patients comfort than that in the NPPV group. There was no significant difference in ICU LOS, ICU mortality and in-hospital 28-day mortality between the two groups. CONCLUSIONS: HFNC and NPPV have similar efficacy in the sequential treatment of sepsis patients after weaning from MV. Compared with NPPV, those extubated to HFNC had lower rate of complications such as reflux aspiration and facial pressure ulcers. The patients extubation to HFNC is more comfortable (and associated with less delirium) than to NPPV. SN - 2224-5839 UR - https://www.unboundmedicine.com/medline/citation/34237954/Comparative_study_of_high_flow_nasal_catheter_device_and_noninvasive_positive_pressure_ventilation_for_sequential_treatment_in_sepsis_patients_after_weaning_from_mechanical_ventilation_in_intensive_care_unit_ L2 - https://doi.org/10.21037/apm-21-8 DB - PRIME DP - Unbound Medicine ER -