Application of pernasal high-flow oxygen therapy in treatment of severe pneumonia complicating with acute respiratory distress syndrome

  Objective     To analyze application effect of high-flow nasal cannula oxygen therapy (HFNC) in patients with severe pneumonia (SP) complicating with acute respiratory distress syndrome (ARDS).

  Methods     A total of 90 SP patients with ARDS were selected as the study objects, and divided into experimental group (n=47) and control group (n=43) by random number table method. Both groups were given symptomatic treatment such as anti-infection, fluid resuscitation and nutritional support. The control group was treated with non-invasive ventilation, and the experimental group was treated with HFNC at the same time. After 1 week of treatment, sputum viscosity, blood gas index, comfort and tolerance, reintubation rate and complications were compared between the two groups.

  Results     The proportions of patients with sputum Ⅰ degree and Ⅱ degree in the experimental group was 95.74%, which was significantly higher than 81.40% in the control group (P < 0.05). Respiratory rate (RR) of the experimental group was significantly lower, arterial partial pressure of oxygenp_a(O₂), oxygen saturation (SaO₂) and oxygenation indexp_a(O₂)/FiO₂ of the experimental group were significantly higher than those of the control group (P < 0.05 or P < 0.01). The scores of comfort, dyspnea and tolerance of the experimental group were significantly lower than those of the control group (P < 0.01 or P < 0.05). The reintubation rate and the total incidence of complications in the experimental group were 6.38% and 8.51%, respectively, which were significantly lower than 23.26% and 25.58% in the control group (P < 0.05).

  Conclusion     HFNC can improve sputum viscosity and blood gas indexes in SP patients with ARDS, improve comfort and tolerance, and reduce the rate of reintubation and complication.