Treatment Effect In The Early Stages Of Acute Carbon Monoxide Poisoning By High Flow Nasal Cannula

Objective(s): To analyze the effects of high flow nasal cannula(HFNC)on blood carboxyhemoglobin(COHb),lactate clearance rate(LCR),neutrophil to lymphocyte ratio(NLR),Glasgow Coma Score(GCS)and Barthel index in patients with acute carbon monoxide poisoning(ACOP),and to provide evidence for the choice of early oxygen therapy for patients with acute carbon monoxide poisoning.Methods: Clinical data of ACOP patients admitted to the emergency Department of the Second Affiliated Hospital of Kunming Medical University from January 2017 to April 2022 were retrospectively analyzed,including gender,age,past history,poisoning site,poisoning route,exposure time,time from poisoning to medical treatment,poisoning cause,vital signs at admission,GCS,Barthel index,main clinical symptoms,clinical symptom relief time,and hospitalization time.According to different oxygen therapy methods,patients were divided into HFNC group and ordinary mask oxygen group.The blood COHb,lactic acid,LCR,oxygenation index,oxyhemoglobin,and total hemoglobin 1 hour after oxygen therapy were compared between the two groups.The GCS,Barthel index,white blood cell count,neutrophil count,lymphocyte count,and NLR 6 hours after oxygen therapy were compared between the two groups.Results: 1.This study included 126 patients,of which 57 were in the HFNC group,with an average age of 46.12±18.91 years old,and 69 were in the conventional face mask oxygen group,with an average age of 40.29±14.28 years old.There was a statistically significant difference in the clinical symptom relief time between the two groups(p<0.05);there was no statistically significant difference(p>0.05)between the two groups in terms of gender,age,route of poisoning,place of poisoning,cause of poisoning,exposure time,time from poisoning to treatment,body temperature,pulse rate,respiratory rate,blood pressure,pulse oxygen saturation,consciousness level,medical history,main clinical symptoms and hospitalization time.2.There were no significant differences in COHb,total hemoglobin,oxygenated hemoglobin,OI,LAC,GCS,Barthel index,WBC,NEUT,LYMPH and NLR between2 groups at admission(p > 0.05).After 1 hour of oxygen therapy,COHb and LAC were lower and LCR were higher in HFNC group than in common mask group,the differences were statistically significant(p < 0.05).There were no significant differences in total hemoglobin,oxygenated hemoglobin and OI between the two groups(p > 0.05).After 6 h of oxygen therapy,NLR and GCS and Barthel index scores of HFNC group were lower and higher than those of common mask group,with statistical significance(p < 0.05).There were no significant differences in WBC,NEUT,and LYMPH between the two groups(p > 0.05).Conclusion(s): Early application of HFNC in ACOP patients can significantly reduce CHOb,NLR,increase LCR,improve GCS and Barthel index scores,and the therapeutic effect of HFNC is better than that of conventional face mask oxygen.