title: Effect of High-Flow Nasal Cannula versus Conventional Oxygen Therapy for Patients with Thoracoscopic Lobectomy after Extubation.
abstract: Objective. To investigate whether high-flow nasal cannula (HFNC) oxygen therapy is superior to conventional oxygen therapy for reducing hypoxemia and postoperative pulmonary complications (PPC) in patients with thoracoscopic lobectomy after extubation.Methods. Patients with intermediate to high risk for PPC were enrolled in this study. Subjects were randomly assigned to HFNC group (HFNCG) or conventional oxygen group (COG) following extubation. Arterial blood samples were collected after extubation at 1, 2, 6, 12, 24, 48, and 72 h. Patients with postoperative hypoxemia and PPC were recorded. Adverse events were also documented.Results. Totally 110 patients were randomly assigned to HFNCG (n= 56) and COG (n= 54). The occurrence rate of hypoxemia in COG was twice more than that in HFNCG (29.62% versus 12.51%,P< 0.05) and PaO2, PaO2/FiO2, and SaO2/FiO2were significantly improved in HFNCG (P< 0.05) in the first 72 h following extubation. Respiratory rate and incidence of reintubation as well as needing noninvasive ventilation were also decreased in HFNCG (P< 0.05), whereas the incidence of pneumonia and atelectasis were similar (P> 0.05). Adverse effects as throat and nasal pain occurred more frequently in COG.Conclusions. HFNC application improves oxygenation and reduces the risk of reintubation following thoracoscopic lobectomy but cannot decrease the incidence of PPC.
authors.affiliation: Department of Critical Care Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Yuetian
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Thoracic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Xiaozhe
authors.initials: X
authors.lastname: Qian
authors.affiliation: Department of Emergency Medicine, Min Hang Central Hospital, School of Medicine, Fu Dan University, Shanghai, China.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Emergency, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Cheng
authors.identifier: 0000-0002-0846-6740
authors.initials: C
authors.lastname: Zhu
mesh_terms: D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage*; D011013:Pneumonectomy; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000295:instrumentation*; D013906:Thoracoscopy
chemical_list: D010100:Oxygen