High-flow nasal cannula oxygen therapy is equally effective to noninvasive ventilation for mild-moderate acute respiratory distress syndrome in patients with acute pancreatitis: A single-center, retrospective cohort study

被引：0
作者：
Zhu, Qingcheng [1 ]
Zhou, Wenzhen [1 ]
Ling, Bingyu [1 ]
Wang, Huihui [1 ]
Tan, Dingyu [1 ]
机构：
[1] Yangzhou Univ, Dept Emergency Med, Clin Med Coll, Northern Jiangsu Peoples Hosp, Yangzhou, Jiangsu, Peoples R China
来源：
SAUDI JOURNAL OF GASTROENTEROLOGY | 2024年 / 30卷 / 05期
关键词：
Acute respiratory distress syndrome; high-flow nasal cannula oxygen; noninvasive ventilation; pancreatitis; FAILURE; INTUBATION; MANAGEMENT; OUTCOMES;
D O I：
10.4103/sjg.sjg_24_24
中图分类号：
R57 [消化系及腹部疾病];
学科分类号：
摘要：
Background: The use of high-flow nasal cannula (HFNC) oxygen therapy is gaining popularity for the treatment of acute hypoxic respiratory failure. However, limited evidence exists regarding the effectiveness of HFNC for acute respiratory distress syndrome (ARDS) in patients with acute pancreatitis (AP). Methods: This retrospective analysis focused on AP patients with mild-moderate ARDS, who were treated with either HFNC or noninvasive ventilation (NIV) in the emergency medicine department, from January 2020 to December 2022. The primary endpoint was treatment failure, defined as either invasive ventilation or a switch to any other study treatment (NIV for patients in the NFNC group and vice versa). Results: A total of 146 patients with AP (68 in the HFNC group and 78 in the NIV group) were included in this study. The treatment failure rate in the HFNC group was 17.6% and 19.2% in the NIV group - a risk difference of -1.6% (95% CI, -11.3 to 14.0%; P = 0.806). The most common causes of failure in the HFNC group were aggravation of respiratory distress and hypoxemia. However, in the NIV group, the most common reasons for failure were treatment intolerance and exacerbation of respiratory distress. Treatment intolerance in the HFNC group was significantly lower than that in the NIV group (16.7% vs 60.0%, 95% CI -66.8 to -6.2; P = 0.023). Multivariate logistic regression analysis showed that body mass index (>= 28), acute physiology and chronic health evaluation II score (>= 15), partial arterial oxygen tension/fraction of inspired oxygen (<= 200), and respiratory rate (>= 32/min) at 1 hour were independent predictors of HFNC failure. Conclusion: In AP patients with mild-moderate ARDS, the usage of HFNC did not lead to a higher rate of treatment failure when compared to NIV. HFNC is an ideal choice of respiratory support for patients with NIV intolerance, but clinical application should pay attention to the influencing factors of its treatment failure.
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页码：302 / 309
页数：8
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