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| Application of humidified high flow nasal cannula in respiratory failure patients post-esophagectomy for esophageal cancer |
| Chen Geng-jing, Xu Hong-yang, Pan Hong, Yan Jie, Yan Zheng |
| Intensive Care Unit, Wuxi People′s Hospital of Nanjing Medical University, Wuxi 214023, China |
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Abstract Objective To evaluate the efficacy of humidified high flow nasal cannula (HFNC) in acute respiratory failure (ARF) patients post-esophagectomy for esophageal cancer. Methods The patient with acute respiratory failure following esophagectomy for esophageal cancer form April 2013 to April 2017 were enrolled. From April 2013 to April 2015, the ARF patients were treated with mask oxygen-inspiration into control group (group A); from May 2015 to April 2017, the patients with ARF were treated by HFNC into observation group (group B).The following factors were evaluated in two groups: gender, age, APACHEⅡ score, FEV1%pred, intraoperative hemorrhage, the oxygenation before and two hours after HFNC therapy, the performing mode of HFNC, the level of fraction oxygenation, the length of ICU-stay and 28-day mortality. Results There were 362 patients underwent the esophagectomy for esophageal cancer from April 2013 to April 2015, 45 patients (12.4%) who met the criterion were enrolled in group A. There were 387 patients underwent the esophagectomy for esophageal cancer from May 2015 to April 2017, 43 patients (11.1%) who met the criterion were enrolled in group B.There was no significant difference in gender, APACHEⅡ, FEV1%pred, intraoperative hemorrhage between two groups(all P＞0.05). There was no significant difference in oxygenation index before HFNC therapy between group A and group B (t=1.658, P＞0.05). The oxygenation index of group B was significant higher than that of group A (t=3.380, P＜0.05］.The rates of reintubation (16.2%) in group B was lower thangroup A (42.2%), and the difference was statistically significant (t=2.140, P＜0.05).The length of ICU-stay in group B was significantly shorter than that in group A ［(4.20±1.08)d vs (12.50±4.85)d, t=3.520, P=0.004］. Only one patient died finally in group B (2.3%,1/43). The 28-day mortality in group B was significantly shorter than that in group A ［(8.8%,4/45), t=2.95, P＜0.05］. Conclusion HFNC can improve the oxygenation, decrease the incidence of intubation and shorten the length of ICU-stay and the 28-day mortality of ARF patients post-esophagectomy for esophageal cancer.
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Corresponding Authors:
Xu Hong-yang, E-mail: 940216583@qq.com
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