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Heated humidified high-flow nasal cannula oxygen after thoracic surgery - A randomized prospective clinical pilot trial.

Abstract：

BACKGROUND:Thoracic surgery patients are at high-risk for adverse pulmonary outcomes. Heated humidified high-flow nasal cannula oxygen (HHFNC O2) may decrease such events. We hypothesized that patients randomized to prophylactic HHFNC O2 would develop fewer pulmonary complications compared to conventional O2 therapy. METHODS AND PATIENTS:Fifty-one patients were randomized to HHFNC O2 vs. conventional O2. The primary outcome was a composite of postoperative pulmonary complications. Secondary outcomes included oxygenation and length of stay. Continuous variables were compared with t-test or Mann-Whitney-U test, categorical variables with Fisher's Exact test. RESULTS:There were no differences in postoperative pulmonary complications based on intention to treat [two in HHFNC O2 (n=25), two in control (n=26), p=0.680], and after exclusion of patients who discontinued HHFNC O2 early [one in HHFNC O2 (n=18), two in control (n=26), p=0.638]. Discomfort from HHFNC O2 occurred in 11/25 (44%); 7/25 (28%) discontinued treatment. CONCLUSIONS:Pulmonary complications were rare after thoracic surgery. Although HHFNC O2 did not convey significant benefits, these results need to be interpreted with caution, as our study was likely underpowered to detect a reduction in pulmonary complications. High rates of patient-reported discomfort with HHFNC O2 need to be considered in clinical practice and future trials.

journal_name

J Crit Care

journal_title

Journal of critical care

authors

Brainard J,Scott BK,Sullivan BL,Fernandez-Bustamante A,Piccoli JR,Gebbink MG,Bartels K

doi

10.1016/j.jcrc.2017.04.023

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

225-228

eissn

0883-9441

issn

1557-8615

pii

S0883-9441(16)31031-0

journal_volume

40

pub_type

杂志文章,随机对照试验

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