Changes in arterial blood gases after use of high-flow nasal cannula therapy in the ED

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• 作者：Jin Hee Jeong ; MD ; Dong Hoon Kim ; MD ; PhD ; ^{kloud14@hanmail.net" class="auth_mail" title="E-mail the corresponding author} ; Seong Chun Kim ; MD ; Changwoo Kang ; MD ; Soo Hoon Lee ; MD ; Tae-Sin Kang ; MD ; Sang Bong Lee ; MD ; Sang Min Jung ; MD ; Dong Seob Kim ; MD
• 刊名：The American Journal of Emergency Medicine
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：33
• 期：10
• 页码：1344-1349
• 全文大小：416 K

文摘

A high-flow nasal cannula (HFNC) has been used to treat patients with dyspnea. We identified changes in arterial blood gas (ABG) of patients visiting the emergency department (ED) with hypercapnic and nonhypercapnic respiratory failure after use of an HFNC.

Methods

This study was a retrospective chart review of patients with respiratory failure who visited the hospital and used an HFNC in the ED. The study period was July 1, 2011, to December 31, 2013. Patients with Paco₂ greater than 45 mm Hg before the HFNC ABG analyses were included in the hypercapnia group; others comprised the nonhypercapnia group. Primary outcomes were the changes in ABG before and after use of an HFNC in the hypercapnia and nonhypercapnia groups. Progression to noninvasive or invasive ventilation and mortality rates were also assessed.

Results

A total of 173 patients were included after exclusion of 92 according to exclusion criteria. Eighty-one patients (hypercapnia group, 46, and nonhypercapnia group, 35) were included. Paco₂ significantly decreased among all patients after use of HFNC (from 54.7 ± 26.4 mm Hg to 51.3 ± 25.8 mm Hg; P = .02), but the reduction was significant only in the hypercapnia group (from 73.2 ± 20.0 to 67.2 ± 23.4; P = .02). Progression to noninvasive or invasive ventilation and mortality rates were similar between the groups.

Conclusions

Use of an HFNC in patients with hypercapnia could show a significant trend of decrease in Paco₂. Progression to noninvasive or invasive ventilation and mortality rates were similar in patients with and without hypercapnia.