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

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 HFN...

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Autores principales: Halub, Meghan E, Spilman, Sarah K, Gaunt, Kristina A, Lamb, Keith D, Jackson, Julie A, Oetting, Trevor W, Sahr, Sheryl M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Canadian Society of Respiratory Therapists 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422229/
https://www.ncbi.nlm.nih.gov/pubmed/30996619
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author Halub, Meghan E
Spilman, Sarah K
Gaunt, Kristina A
Lamb, Keith D
Jackson, Julie A
Oetting, Trevor W
Sahr, Sheryl M
author_facet Halub, Meghan E
Spilman, Sarah K
Gaunt, Kristina A
Lamb, Keith D
Jackson, Julie A
Oetting, Trevor W
Sahr, Sheryl M
author_sort Halub, Meghan E
collection PubMed
description 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 (r (s) = 0.41, p = 0.001) and ICU days (r (s) = 0.41, p < 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.
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spelling pubmed-64222292019-04-17 High-flow nasal cannula therapy for patients with blunt thoracic injury: A retrospective study Halub, Meghan E Spilman, Sarah K Gaunt, Kristina A Lamb, Keith D Jackson, Julie A Oetting, Trevor W Sahr, Sheryl M Can J Respir Ther Research Article 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 (r (s) = 0.41, p = 0.001) and ICU days (r (s) = 0.41, p < 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. Canadian Society of Respiratory Therapists 2016-11-01 2016 /pmc/articles/PMC6422229/ /pubmed/30996619 Text en http://creativecommons.org/licenses/by-nc/4.0/ This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (http://creativecommons.org/licenses/by-nc/4.0/), which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes. For commercial reuse, contact editor@csrt.com
spellingShingle Research Article
Halub, Meghan E
Spilman, Sarah K
Gaunt, Kristina A
Lamb, Keith D
Jackson, Julie A
Oetting, Trevor W
Sahr, Sheryl M
High-flow nasal cannula therapy for patients with blunt thoracic injury: A retrospective study
title High-flow nasal cannula therapy for patients with blunt thoracic injury: A retrospective study
title_full High-flow nasal cannula therapy for patients with blunt thoracic injury: A retrospective study
title_fullStr High-flow nasal cannula therapy for patients with blunt thoracic injury: A retrospective study
title_full_unstemmed High-flow nasal cannula therapy for patients with blunt thoracic injury: A retrospective study
title_short High-flow nasal cannula therapy for patients with blunt thoracic injury: A retrospective study
title_sort high-flow nasal cannula therapy for patients with blunt thoracic injury: a retrospective study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422229/
https://www.ncbi.nlm.nih.gov/pubmed/30996619
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