HIỆU QUẢ CỦA THỞ OXY LÀM ẨM DÒNG CAO QUA CANULA MŨI SAU RÚT ỐNG NỘI KHÍ QUẢN Ở BỆNH NHÂN ĐỢT CẤP BỆNH PHỔI TẮC NGHẼN MẠN TÍNH

Abstract

Objectives: To evaluate  the effectiveness of humidified high-flow oxygen nasal canula after extubation in patients with acute exacerbation of chronic obstructive pulmonary disease.Method: A prospective interventional study,  all patients eligible for the study was chosen. The patient was applied HFNC immediately after extubation. Clinical indicators and blood gases after extubation were collected. Success of HFNC defined as the patient did not require reintubation or noninvasive ventilation within 48 hours of extubation. The study was conducted from May 2022 to June 2023 at the Center for Critical Care Medicine - Bach Mai Hospital. Results: There were 31 patients participating in the study. In which, there were 28 male patients (90,3%), 3 female patients (9,7%). The mean age was 70,58±9,319 years old, the oldest was 84 years old, the lowest was 49 years old. Most common comorbidities were hypertension (25,8%) and heart failure (22,8%). The success rate was 77,42%. HFNC improved clinical signs on the patients: pulse, respiratory rate, SpO₂. The change in blood gas indices such as pH, PaCO₂, PaO₂ was not statistically significant with p > 0,05 in successful and failed group. The pH and PaCO2 indices were significantly different with p < 0,05 between 2 groups at 30 minutes and 2 hours after extubation. 100% of patients improve their expectoration and sputum properties. Conclusion: HFNC is an effective tool to reduce the risk of re-intubation in patients with COPD exacerbations.