Abstract
OBJECTIVE: To compare the short term benefit of high-flow nasal oxygen cannula (HFNC) with non-rebreathing mask in terms of change of dyspnea, physiologic variables, and patient comfort in subjects after endotracheal extubation.
METHODS: A randomized cross-over study was conducted in a 10-bed respiratory care unit in a university hospital. Seventeen mechanically ventilated subjects were randomized after extubation to either Protocol A—applied HFNC for 30 min, then followed by non-rebreathing mask for another 30 min, or Protocol B—applied non-rebreathing mask for 30 min, then followed by HFNC for another 30 min. Level of dyspnea, respiratory rate, heart rate, blood pressure, oxygen saturation, and patient comfort were recorded. The results were expressed as mean±standard deviation (SD), frequency, or percentage. Categorical variables were compared by Chi-squared test or Fisher’s exact test and continuous variables were compared by dependent or pair t-test. Statistical significance was defined at P < .05.
RESULTS: Seventeen subjects were divided into two groups: 9 subjects were applied for protocol A whereas 8 subjects for protocol B. The baseline characteristics and physiologic parameters before extubation were not so different in each protocol. At the end of study, HFNC indicated less dyspnea (P = .04), lower respiratory rate (P = .009), and heart rate (P = .006) when compared with non-rebreathing mask. Most of subjects (88.2%) preferred HFNC to non-rebreathing mask.
CONCLUSIONS: HFNC can improve dyspnea and physiologic parameters in extubated subjects, including respiratory rate and heart rate when compared with conventional oxygen therapy. This device may have a potential role after endotracheal extubation.
- High-flow nasal oxygen cannula
- Non-rebreathing mask
- Endotracheal extubation
- Oxygen therapy
- Non-invasive ventilation
Footnotes
- Correspondence: Nuttapol Rittayamai MD, Division of Respiratory Diseases and Tuberculosis, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkoknoi, Bangkok 10700, Thailand. E-mail: nuttapol.rit{at}mahidol.ac.th. Tel.: +6624197757 (press 11), Fax: +6624197760.
The authors have disclosed no conflicts of interest.
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