Effect of high-flow nasal cannula on blood gas parameters,inflammatory markers,and clinical conditions in adult patients with severe pneumonia and respiratory failure
Objective To investigate the effects of high-flow nasal cannula(HFNC)on blood gas parameters,inflammatory markers,and clinical conditions in adult patients with severe pneumonia and respiratory failure,and compare the efficacy of noninvasive positive pressure ventilation(NIPPV)with it.Methods A retrospective analysis was performed on 95 adult patients with severe pneumonia and respiratory failure treated in Yan'an Hospital of Traditional Chinese Medicine from January 2021 to October 2023.Forty-five patients who received NIPPV were assigned to the control group,and 50 patients who underwent HFNC treatment were assigned to the observation group.In the observation group,there were 28 males and 22 females,aged(63.64±4.31)years.In the control group,there were 24 males and 21 females,aged(64.38±4.57)years.The two groups were compared in terms of blood gas parameters[arterial partial pressure of oxygen(Pa02),arterial partial pressure of carbon dioxide(PaCO2),and oxygen saturation(SaO2)],respiratory rate(RR),sputum viscosity,inflammatory markers[tumor necrosis factor(TNF)-α,interleukin(IL)-6,high mobility group protein B1(HMGB-1),high-sensitivity C-reactive protein(hs-CRP),and soluble myeloid cell trigger receptor(sTREM)],and changes in condition[Borg scale and Pneumonia Severity Index(PSI)scores]before treatment and 1 week after treatment,treatment efficiency,and complications.Independent sample t test andx2test were used.Results After treatment,the PaO2,RR,PaCO2,and SaO2 in the observation group were(92.19±5.76)mmHg(1 mmHg=0.133 kPa),(20.71±2.81)times/min,(45.99±5.33)mmHg,and(93.30±9.39)％,those in the control group were(82.99±6.33)mmHg,(23.68±2.96)times/min,(48.19±5.76)mmHg,and(83.50±9.43)％,with statistically significant differences between the two groups(all P＜0.05).The phlegm viscosity of the observation group was lower than that of the control group after treatment(P=0.017).The levels of inflammatory factors in the observation group decreased after treatment compared with those before treatment,and there were statistically significant differences compared with those in the control group[the levels of TNF-α,IL-6,HMGB-1,hs-CRP,and sTREM in the observation group were(17.83±5.70)mg/L,(19.46±5.47)ng/L,(113.05±28.36)μg/L,(33.23±4.08)mg/L,and(15.95±2.68)ng/L,and those in the control group were(32.02±7.44)mg/L,(33.50±5.62)ng/L,(216.46±25.11)μg/L,(53.91±6.14)mg/L,and(35.89±4.49)ng/L](all P＜0.001).After treatment,the Borg index and PSI scores of the observation group were(3.48±0.39)and(67.99±7.82)points,which were lower than those of the control group[(4.34±0.48)and(78.97±8.98)points],with statistically significant differences(both P＜0.001).The weaning time,hospital stay,dyspnea relief time,and disappearance time of pulmonary rales in the observation group were(3.63±0.72),(7.75±1.16),(1.04±0.36),and(4.32±0.77)d,which were shorter than those in the control group[(4.75±0.85),(8.46±1.33),(1.64±0.51),and(5.88±1.06)d],with statistically significant differences(all P＜0.05).There was no statistically significant difference in the total incidence of complications between the two groups(P＞0.05).Conclusion HFNC therapy has a positive effect on adult patients with severe pneumonia and respiratory failure,effectively improving blood gas parameters,reducing inflammatory markers,and decreasing sputum viscosity,thus facilitating recovery.
Severe pneumoniaRespiratory failureHigh-flow nasal cannulaNoninvasive positive pressure ventilationBlood gas parameters
万方数据
维普
