Effects of Post-Tracheotomy Sequential Transnasal High-flow Humidification and Oxygenation Therapy on Respiratory Tract Infection and Clinical Outcomes in Elderly Patients with Chronic Obstructive Pulmonary Disease Complicated with Type Ⅱ Respiratory Failure
SI Yan, ZHANG Na-na
Department of Intensive Care Rehabilitation,the Third Hospital of Shandong Province,Jinan Shandong 250031
Abstract：【Objective】To explore the effect of post-tracheotomy sequential transnasal high-flow humidification and oxygen therapy on respiratory tract infection and clinical outcomes in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure. 【Methods】A total of 96 elderly patients with COPD and type Ⅱ respiratory failure,who were admitted to the hospital for tracheotomy from May 2018 to May 2020,were selected and divided into the observation group and the control group. According to the random number table method,there were 48 cases in each group. The control group was treated with non-invasive positive pressure ventilation,while the observation group was treated with sequential nasal high-flow humidification and oxygen therapy. The average sputum suction times,sputum viscosity,respiratory tract infection,spontaneous breathing time,ICU stay time,clinical efficacy,respiratory dynamics,blood gas analysis,pulmonary function and adverse reactions were compared between the two groups. 【Results】The average number of sputum suctions,spontaneous breathing time,ICU stay time,and incidence of respiratory tract infection in the observation group were lower than those in the control group (P<0.05). There was no significant difference in the 28-day mortality between the observation group and the control group (P>0.05). The total effective rate of the observation group was higher than that of the control group (P<0.05). After treatment,the average airway pressure and airway resistance of the observation group were lower than those of the control group (P<0.05). After treatment,the blood partial pressure of oxygen (PaO2) in the observation group was higher than that in the control group (P<0.05),and the blood carbon dioxide partial pressure (PaCO2) in the observation group was lower than that in the control group (P<0.05). After treatment,the forced expiratory volume in one second (FEV1) and FEV1/forced vital capacity (FVC) of the observation group were higher than those of the control group. There was no significant difference in the incidence of adverse reactions between the observation group and the control group (P>0.05). 【Conclusion】 Sequential nasal high-flow humidification and oxygenation therapy after tracheotomy in elderly patients with chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure can reduce the rate of respiratory tract infection,improve clinical outcomes,and improve lung function at the same time,which is safe and reliable.
司艳, 张娜娜. 老年COPD合并Ⅱ型呼吸衰竭患者气管切开术后采用序贯经鼻高流量加温湿化氧疗对患者呼吸道感染及临床结局的影响[J]. 医学临床研究, 2023, 40(5): 706-709.
SI Yan, ZHANG Na-na. Effects of Post-Tracheotomy Sequential Transnasal High-flow Humidification and Oxygenation Therapy on Respiratory Tract Infection and Clinical Outcomes in Elderly Patients with Chronic Obstructive Pulmonary Disease Complicated with Type Ⅱ Respiratory Failure. JOURNAL OF CLINICAL RESEARCH, 2023, 40(5): 706-709.
2023, Vol. 40 
