Comparison of the efficacy of high flow nasal therapy and non-invasive ventilation in the treatment of hypoxic patients with heart failure:a retrospective cohort study
Objective To compare the efficacy of high flow nasal therapy(HFNC)with non-invasive ventilation(NIV)in hypoxic patients with heart failure(HF).Methods Data of 694 HF patients admitted to ICU between 2008 and 2019 were obtained from the US Multiparameter Intelligent Monitoring in Intensive Care Ⅳ database.According to the use of HFNC or NIV during hospitalization,the patients were divided into the HFNC group with 459 cases and the NIV group with 235 cases.The differences of population baseline,comorbidities,combined heart disease,laboratory indicators,vital signs indicators and clinical outcomes were compared between the two groups.Kaplan-Meier curve was drawn,and the 28-day cumulative survival rate between the two groups was compared by log-rank test.Multivariate logistic regression model was used to control possible confounding factors,and the treatment failure rate within 48 h was compared between HFNC group and NIV group.Multivariate Cox regression model was used to control confounding factors,and the 28-d mortality was compared between the two groups.According to the oxygenation index(Ol),the patients were divided into OI≥100 subgroup and OI＜100 subgroup.Subgroups were analyzed for the treatment failure within 48 h and 28-d mortality in patients with HFNC and NIV.Results There were significant differences in body weight,COPD,coronary artery disease,pH,base excess,PaCO2,OI,length of hospital stay,ICU stay,and oxygen therapy time between the two groups(all P＜0.05).However,the treatment failure rate within 48 h and 28-d mortality were not significantly different between the two groups(both P＞0.05).After adjusting for potential confounding factors using a multivariate logistic regression model,there was no statistically significant difference in the treatment failure rate within 48 h between the HFNC group and NIV group(OR=0.895,95％CI:0.568-1.412,P=0.634).Furthermore,following adjustment for confounders through a multivariate Cox regression model,there was no significant difference in 28-d mortality between the HFNC group and NIV group(HfR=1.006,95％CI:0.685-1.479,P=0.975).After adjusting for confounders,the results of subgroup analysis showed that the differences in the treatment failure rates within 48 h and 28-d mortality between the HFNC and NIV patients were not statistically significant(all P＞0.05).Conclusion HFNC and NIV are two different oxygen therapy methods to correct hypoxia in patients with HF.The therapeutic effect of HFNC is not inferior to that of NIV.Different oxygen therapy methods can be selected according to the different needs of patients in the clinical use.
万方数据
维普
