Clinical effect of HFNC in mechanical ventilation evacuation sequential therapy for patients with severe pneumonia
Objective To investigate the clinical efficacy of high flow nasal cannula(HFNC)in sequential mechanical ventilation evacuation therapy for severe pneumonia patients,and to analyze the impact of the regimen on sputum humidification and arterial oxygen partial pressure after 24 hours of evacuation.Meth-ods A total of 118 severe pneumonia patients admitted to Chongming Hospital Affiliated to Shanghai Medical College of Health from January 2019 to December 2022 were selected.The patients were randomly divided into a control group and an experimental group,with 59 patients in each group using a random number table method.The control group received non-invasive positive pressure ventilation,while the ex-perimental group received HFNC.Clinical indicators(total mechanical ventilation time,hospital stay),sputum wetting effect after 24 hours of evacuation,and sputum viscosity were compared between the 2 groups blood gas indicators[arterial oxygen partial pressure(PaO2),carbon dioxide partial pressure(PaCO2),vital signs(respiratory rate,heart rate),reintubation rate,incidence of adverse reactions].Re-suIts The total mechanical ventilation time and hospitalization time of the experimental group patients were shorter than those of control group(P<0.05).The satisfaction rate of humidification in the experi-mental group(81.36%)was higher than that in control group(49.15%),and the difference was statisti-cally significant(P<0.05).In the experimental group,there were 31 patients(52.54%),24 patients(40.68%)and 4 patients(6.78%)with sputum viscosity of grade Ⅰ,Ⅱ,and Ⅲ,respectively.The difference in sputum viscosity between the experimental group and the control group was statistically sig-nificant(P<0.05).After thetreatment,both groups of the patients had an increase in PaO2 and a de-crease in PaCO2,and the experimental group had significantly higher PaO2 than the control group,while PaCO2 was significantly lower than the control group(P<0.05).After thetreatment,the respiratory rate and heart rate of both groups of the patients wasdecreased,and the respiratory rate and heart rate of the experimental group were significantly lower than those of the control group(P<0.05).The reintubation rate of the patients in the observation group(3.39%)was lower than that in the control group(18.64%),and the incidence of adverse reactions(8.47%)was lower than that in the control group(32.20%),with a statistically significant difference(P<0.05).Conclusion Providing HFNC treatment to SP patients during mechanical ventilation evacuation sequential treatment can promote patient recovery,improve the sputum wetting effect and viscosity 24 hours after evacuation,improve the patient's blood oxygen status and vital signs,and reduce the incidence of adverse reactions and reintubation rates.
sequential treatment of mechanical ventilation evacuationhigh-flow nasal cannula oxygen ther-apysevere pneumoniaphlegm humidificationarterial partial pressure of oxygen