Use Of High-flow Nasal Cannula Oxygen Therapy Compared With Noninvasive Positive Pressure Ventilation Immediately Following Early Extubation In Patients With Acute Respiratory Distress Syndrome

Objective: To investigate the advantages and disadvantages of nasal high flow humidification oxygen therapy(HFNC)and noninvasive positive pressure ventilation(NIPPV)in sequential treatment of patients with acute respiratory distress syndrome(ARDS)after early extubation.Methods: from September 2018-September 2020 in the first affiliated hospital of xinjiang medical university breathing to strengthen medical wards(RICU)last for ARDS patients in the hospital as the research object,endotracheal intubation and mechanical ventilation(ETI-MV)of patients included in the study,when "oxygenation index ≧ 200 mm Hg" to root out endotracheal intubation,randomly divided into two groups,a group given HFNC treatment(namely HFNC group),another group of NIPPV treatment group(NIPPV).The baseline data of the two groups were recorded,and the incidence of reintubation events,case fatality rate,adverse treatment events(such as abdominal distension,aspiration,facial compression,corneal conjunctivitis,claustrophobia,sputum disturbance),ICU stay and total length of stay were compared between the two groups 7 days after extubation.RESULTS: A total of 63 subjects were included,including 30 in the HFNC group and 33 in the NIPPV group.Compared with the NIPPV group,the reintubation rate at 7 days after extubation in the HFNC group was significantly lower than that in the NIPPV group [3.3%(1/30)vs.21.2%(7/33),P<0.05],the fatality rate in the HFNC group was significantly lower than that in the NIPPV group[3.3%(1/30)vs.24.2%(8/33),P<0.05],and the length of hospitalization in the HFNC group was significantly lower than that in the NIPPV group [(14.63±6.69)d vs.(20.72±15.52)d,P<0.05].The total hospital stay in HFNC group was significantly lower than that in NIPPV group [(22.43±10.33)d vs.(29.31±13.42)d,P < 0.05],and the incidence of adverse events in HFNC group was significantly lower than that in NIPPV group [3.3%(1/30)vs.36.4%(12/33),P<0.05].Conclusion: In ARDS patients,sequential HFNC may be better than NIPPV after early removal of endotracheal intubation,with fewer reintubation events,lower case fatality rate,shorter hospitalization time and total hospitalization time of ICU,and higher comfort level.