Guoji laonian yixue zazhi (Jan 2024)
Application Value of Blood Lactate and ROX Index in Humidification High-flow NasalCannula Oxygen Therapy for Elderly Patients with Acute Exacerbationof Chronic Obstructive Pulmonary Disease
Abstract
Objective To investigate the application value of blood lactic acid(Lac) and ROX index in the treatment of elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) by nasal humidification high-flow oxygen therapy(HFNC). Methods A total of 82 patients with AECOPD who visited the Department of Respiratory and Critical Care Medicine of the Second Medical Center of the PLA General Hospital from March 2020 to March 2023 were selected as the study subjects and treated with HFNC.Patients were divided into effective(n=53) and ineffective(n=29) groups according to the continuous treatment of HFNC for 48 h.The clinical data and serum Lac and ROX indices were compared between the two groups,and the related factors affecting the ineffective treatment of HFNC were analyzed by a mlogistic regression model,the predictive value of blood Lac and ROX indices for the ineffective treatment of HFNC was analyzed by ROC curve. Results The age,acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score,C-reactive protein(CRP),blood Lac before and 12 h after treatment in the ineffective group were all higher than those in the effective group(P<0.05),and albumin(ALb) levels,oxygenation index,and ROX index before and 12 h after treatment were lower than those in the effective group(P<0.05).Multivariate logistic regression analysis showed that high APACHE Ⅱ score and high blood Lac before and 12 h after treatment were risk factors affecting the ineffective treatment of HFNC(P<0.05),and high ROX index before and 12 h after treatment were protective factor for the effective treatment of HFNC(P<0.05).ROC curves showed that the AUC(95% CI) of blood Lac before treatment and 12 hours after treatment,ROX index before treatment and 12 hours after treatment for predicting ineffective HFNC treatment were 0.680(0.568~0.779),0.730(0.621~0.822),0.776(0.670~0.860),and 0.823(0.723~0.899),respectively. Conclusion High blood Lac level and low ROX index before and 12 h after HFNC treatment in elderly patients with AECOPD are risk factors affecting the failure of HFNC continuous treatment for 48 h,and blood Lac and ROX index before and 12 h after HFNC treatment can be used as a reliable reference index to evaluate the therapeutic effect of HFNC.
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