Comparison between the effect of heated and humidified high-flow nasal oxygen and conventional oxygen during acute hypoxemic respiratory failure

Abstract

Abstract Background Hypoxemia is the most serious threat to organ function. Therefore, the goal is to reverse tissue hypoxia. The aim of this study was to compare heated and humidified high-flow nasal cannula (HFNC) with conventional low-flow nasal cannula (LFNC) oxygen therapy in acute hypoxemic respiratory failure (RF). Patients and methods This prospective study was conducted on 60 patients with acute hypoxemic RF. Patients were randomly classified into two groups. Group I received LFNC oxygen therapy. Group II received heated humidified HFNC oxygen therapy. Comparison between the two groups was made using dyspnea scales, heart rate, respiratory rate, and oxygenation status. Results There were no statistically significant differences as regards age, sex, smoking status, causes of RF, and presence of comorbidities between the two groups. There was no statistically significant difference in the modified Borg scale and visual analog scale (VAS) score between the two groups at baseline (P>0.05). After 24 h, the HFNC group had a significant decrease in these scores (P<0.05). Respiratory rate and heart rate significantly decreased, whereas arterial oxygen saturation and tension increased significantly in the HFNC group compared with the conventional LFNC group (P<0.05). Only one patient in the HFNC group versus three patients in the LFNC group required mechanical ventilation. Two patients experienced nasal discomfort in the HFNC group versus five patients in the LFNC group. Conclusion Treatment of acute hypoxemic RF with HFNC was associated with better and rapid improvement in oxygenation when compared with LFNC, with fewer side effects, better convenience, and lesser need for mechanical ventilation.

Keywords

• acute respiratory failure
• heated and humidified oxygen
• high-flow oxygen