Comparative study of high-flow oxygen therapy versus conventional oxygen therapy for acute cardiogenic pulmonary edema
Objective To compare the effect of high-flow oxygen therapy versus conventional oxygen therapy for acute cardiogenic pulmonary edema.Methods It was a prospective randomized controlled study involving 62 patients with acute cardiogenic pulmonary edema complicated with hypoxemia from February 2019 to October 2021.They were randomly divided into routine group(n = 32)and high-flow oxygen thercpy group(n = 30).Patients in the routine group were given conventional oxygen therapy until the fraction of inspired oxygen(FiO2)reached 50%by oxygen inhalation with a Venturi mask or nasal catheter,and the target oxygen saturation(SpO2)maintained at 90%-96%.Patients in the high-flow oxygen thercpy group were treated with high-flow oxygen therapy using the Optiflow nasal high-flow warming and humidification oxygen therapy system(AIRVO 2 respiratory humidification therapeutic apparatus),which consistently deliverd a high-flow warmed(37℃)and humidified(relative humidity of 100%)air-oxygen mixture above the peak inspiratory flow,with an initial oxygen flow of 4-6L/min(equivalent to 40%-50%of FiO2)and a flow of 60L/min.The oxygen concentration of high-flow nasal cannula(HFNC)was enhanced or reduced by 10%every 5 minutes according to the targeted SpO2.Respiratory parameters,oxygenation index and patient comfort were compared.Results Compared with the routine group,the heart rate(HR)of the high-flow oxygen therapy group decreased at 30min and 60min after oxygen therapy(P<0.01).Meanwhile,there was no significant change in the systolic blood pressure(SBP)at each time point in the high-flow oxygen therapy group(P>0.05).The comfort score in patients receiving HFNC oxygen therapy increased significantly at 60 min(all P<0.01).There were no significant differences in the 24h non-invasive ventilation,24h invasive ventilation and 7-day mortality between groups and within groups(all P>0.05).Conclusion High-flow oxygen therapy can effectively improve the hypoxic state of patients with acute cardiogenic pulmonary edema.Compared with conventional oxygen therapy,it can improve the hypoxic state more quickly and significantly,presenting the advantages of simple procedure,rapid outcomes and good comfort.It is worthy of clinical application.
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