Clinical effect of high-flow nasal cannula oxygen therapy combined with naloxone on severe respiratory failure in older adult patients: a randomized controlled trial.

Objective: To analyze the clinical effect of high-flow nasal cannula (HFNC) oxygen therapy combined with naloxone on severe respiratory failure (SRF) in older adult patients.

Methods: We enrolled 96 older adult patients with SRF who were admitted to Hai'an People's Hospital between February 2019 and March 2022. The patients were divided into two groups: the control group (treated with non-invasive positive pressure ventilation combined with naloxone) and the observation group (treated with HFNC oxygen therapy combined with naloxone). The blood gas measurement, respiratory rate (RR), St. George's Respiratory Questionnaire (SGRQ) score, Clara cell secreted protein (CC16) level, tumor necrosis factor-alpha (TNF-α) level, interleukin-1 (IL-1) level, length of intensive care unit (ICU) stay, tracheal intubation rate, and 28-day mortality rate were compared between the groups.

Results: Blood gas measurement or RR did not differ significantly between the groups (>0.05). The observation group showed improved outcome, including reduced partial pressure of CO, RR, and pH, and increased partial pressure of O (PaO), PaO/fraction of inspired O ratio, and O saturation after treatment (<0.05). Additionally, the observation group exhibited lower TNF-α level, IL-1 level, and SGRQ score, and higher CC16 level (<0.05). The length of ICU stay, tracheal intubation rate, and 28-day mortality rate were lower in the observation group (<0.05).

Conclusions: HFNC oxygen therapy combined with naloxone in older adult patients with SRF could improve blood gas results, disease duration, tracheal intubation rate, and 28-day mortality rate. This may occur through regulation of TNF-α, IL-1, and CC16 expression.