High-flow nasal oxygen therapy versus non-invasive mechanical ventilation in treatment of patients with trauma-associated acute lung injury

  Objective  To compare the efficacy of high-flow nasal oxygen (HFNO) therapy and non-invasive ventilation (NIV) therapy in treatment of patients with trauma-associated acute lung injury.

  Methods  Totally 43 trauma patients with acute lung injury (ALI) were randomly divided into HFNO group (n=20) and NIV group (n=23). The respiratory parameters respiratory rate (RR), partial pressure of arterial oxygen p(O₂), oxygenation index p(O₂)/FiO₂ and circulation parameters heart rate, mean arterial pressure (MAP), lactate before treatment (0 min) and after treatment (60 and 120 min) were compared. At the end of the study, the patients' dyspnea, discomfort and thirst were assessed by visual analogue score.

  Results  Compared with indexes at 0 min, RR at 60 and 120 min decreased significantly in both groups, p(O₂), p(O₂)/FiO₂ increased significantly (P < 0.05), but there were no significant differences in circulatory parameters (heart rate, MAP, lactate) (P>0.05). Compared with indexes at 60 min, there was no significant change in respiratory and circulatory parameters at 120 min between the two groups (P>0.05). There were no significant differences in RR, p(O₂), p(O₂)/FiO₂, heart rate, MAP and lactate between the two groups (P>0.05). The scores of dyspnea, discomfort and thirst in HFNO group were significantly lower than those in NIV group (P < 0.05).

  Conclusion  Both HFNO and NIV can improve oxygenation of ALI patients in a short time, but HFNO is more comfort, and it can be used as an alternative treatment for patients with NIV intolerance.