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High-flow nasal cannula therapy for patients with blunt thoracic injury: A retrospective study. | LitMetric

High-flow nasal cannula therapy for patients with blunt thoracic injury: A retrospective study.

Can J Respir Ther

General Surgery Residency Program, UnityPoint Health, Des Moines, Iowa, 50309, USA.

Published: November 2016

AI Article Synopsis

  • High-flow nasal cannula (HFNC) may help reduce the need for mechanical ventilation and decrease hospital stays for patients with severe respiratory issues, but lacks evaluation in trauma patients with chest injuries.
  • This study analyzed ICU patients with moderate to severe thoracic injuries who received HFNC from 2012 to 2015, focusing on outcomes like intubation rates, hospitalization duration, and mortality.
  • Results showed that 69% of patients using HFNC avoided mechanical ventilation, 92% were discharged alive, and delayed HFNC use was linked to longer hospital stays, indicating potential benefits of HFNC for chest-injured patients warranting further research.

Article Abstract

Objective: High-flow nasal cannula (HFNC) has been shown to reduce the need for mechanical ventilation (MV) and to decrease hospital and ICU days for patients with severe respiratory compromise. HFNC has not been evaluated in trauma patients, thus the goal of this study is to describe the use of HFNC in a chest-injured population.

Methods: A retrospective study examined trauma patients with moderate to severe thoracic injury admitted to the ICU at a tertiary hospital between March 2012 and August 2015. HFNC was delivered by the Fisher & Paykel Optiflow system. Primary outcomes were the need for intubation after HFNC for respiratory failure, length of hospitalization, and mortality.

Results: During the study period, 105 patients with blunt chest trauma were admitted to the ICU and received HFNC therapy. Eighteen percent received MV prior to HFNC. Overall, 69% of patients who received HFNC never received MV, and 92% of patients were discharged alive. The intubation rate for respiratory failure after HFNC was 18%. For patients who did not receive MV prior to HFNC, delay to first HFNC was correlated with increased hospital days ( = 0.41, = 0.001) and ICU days ( = 0.41, < 0.001).

Conclusions: Study results suggest that HFNC is comparable with other methods of noninvasive ventilation and may be beneficial for patients with thoracic injury. Additional investigation is warranted to determine if early use of HFNC can deliver effective respiratory support and prevent intubation in this population.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422229PMC

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