Study on clinical efficacy of heated humidified high-flow nasal cannulae oxygen therapy in patients with acute heart failure and respiratory failure
Objective To explore the clinical effect of heated humidified high flow-nasal cannulae oxygen therapy (HFNC) in patients with acute heart failure (AHF) and respiratory failure. Methods 78 patients with acute heart failure and respiratory failure were selected. The patients were randomly divided into a control group and an observation group,with 39 cases in each group. The control group received low-flow oxygen therapy on the basis of conventional treatment,and the observation group received heated humidified high flow-nasal cannulae oxygen therapy on the basis of conventional treatment. Patients in both groups were compared in terms of effective rate and blood gas indexes[arterial partial pressure of oxygen (PaO2),arterial partial pressure of carbon dioxide (PaCO2)]after 1 and 24 h of treatment,heart rate,respiratory rate,serum C-reactive protein (CRP),B-type natriuretic peptide (BNP) levels before and after treatment,tracheal intubation rate and mortality within 1 month after treatment. Results The effective rates of the observation group at 1 and 24 h after treatment were 79.49％ and 97.44％,which were higher than 51.28％ and 79.49％ of the control group (P<0.05). At 1 and 24 h after treatment,the heart rate and respiratory rate of the observation group were (105.47±3.36) beats/min,(23.42±2.36) times/min and (91.31±2.54) beats/min,(19.45±2.86) times/min,which were lower than (116.72±3.52) beats/min,(27.58±3.52) times/min and (96.30±3.52) beats/min,(22.61±4.01) times/min in the control group (P<0.05). At 1 and 24 h after treatment,PaO2 were (89.94±1.54) and (93.94±2.70) mm Hg (1 mm Hg=0.133 kPa) in the observation group,which were higher than (84.19±2.27) and (89.86±1.53) mm Hg in the control group;PaCO2 were (40.84±4.32) and (35.84±2.37) mm Hg,which were lower than (45.84±3.56) and (44.62±1.38) mm Hg in the control group (P<0.05). At 24 h after treatment,the observation group had serum CRP of (28.42±4.52) mg/L and BNP of (2342.92±24.59) pg/ml,which were lower than (35.98±5.27) mg/L and (3876.65±34.19) pg/ml in the control group (P<0.05). The rate of tracheal intubation in the observation group was 5.13％,which was lower than 20.51％ in the control group (P<0.05). There was no statistical significant difference in mortality within 1 month after treatment (P>0.05) Conclusion Early application of heated humidified high-flow nasal cannulae oxygen therapy shows significant effect for patients with acute heart failure and respiratory failure. It can reduce the rate of tracheal intubation,improve the symptoms of heart failure and improve the therapeutic effect of patients.
万方数据
维普
