Physiologic Effects of High Flow Nasal Cannula Compared to Conventional Oxygen Therapy Postextubation: A Randomized Crossover Study

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dc.catalogadorjlo
dc.contributor.authorBasoalto Escobar, Roque Ignacio
dc.contributor.authorDamiani Rebolledo, Luis Felipe
dc.contributor.authorJalil Contreras, Yorschua Frederick
dc.contributor.authorGarcia, P.
dc.contributor.authorCarpio Cordero, David Bernardo
dc.contributor.authorBachmann Barron, María Consuelo
dc.contributor.authorAlegria Aguirre, Luz Katiushka
dc.contributor.authorOviedo Álvarez, Vanessa Andrea
dc.contributor.authorBugedo Tarraza, Guillermo Jaime
dc.contributor.authorRetamal, J.
dc.contributor.authorBruhn Cruz, Alejandro Rodrigo
dc.date.accessioned2025-12-12T17:45:02Z
dc.date.available2025-12-12T17:45:02Z
dc.date.issued2022
dc.description.abstractRationale: High flow nasal cannula (HFNC) has been shown to generate several physiological which would be responsible forreducing weaning failure rates. However, there are not many physiological studies focused on the post-extubationstage.Objective: To determine the physiological effects of HFNC in the post-extubation period.Methods:Prospective randomizedcrossover study in the post-extubation period of patients with acute respiratory failure (ARF), which was approved by the HealthSciences Scientific Ethics Committee of Pontificia Universidad Católica de Chile. Critically ill patients connected to mechanicalventilation (MV) more than 48 hours, with PaO2/FiO2 <300 mmHg, and in whom the physician planned to perform a spontaneousventilation test (SBT) were included. After obtaining consent informed a catheter with an esophageal and gastric balloon andelectrodes to record the electrical activity of the diaphragm (EAdi) were installed. Moreover, an electrical impedance tomography(EIT) around the chest was connected, arterial and venous blood gases were recorded, in addition to the usual clinical signs.After extubation, the patients were connected to HFNC set at 50 L/min for one hour and conventional oxygen therapy (venturimask) for one hour in a random sequence.Results:Nine patients (6 men) aged 60.7 ± 10.0 years were included. Patients wereconnected to MV for 6.6 ± 3.2 days. Compared with conventional oxygen therapy, HFNC significantly reduces the respiratoryeffort observed by a reduction of esophageal pressure swings (ΔPes)(p= 0.006) and pressure-time product (PTPes) (p= 0.047)of 30% and 27%, respectively. In the HFNC period, the end-expiratory lung impedance (p< 0.001) and dynamic lung compliance(VT/ΔPes) (p= 0.041) was significantly higher. However, no differences were observed in tidal volume (p= 0.255), electricalactivity of the diaphragm (ΔEAdi) (p= 0.104), Neuro-ventilatory efficiency (p= 0.262), and respiratory rate (RR) (p= 0.299)compared to the period of conventional oxygen therapy. Finally, the PaO2 / FiO2 ratio was also higher in the HFNC period (p =0.029).Conclusion:The use of HFNC in the post-extubation period in patients with acute respiratory failure reduces work ofbreathing and is capable of increasing end-expiratory lung volume, dynamic compliance, and gas exchange.
dc.description.funderAgencia nacional de investigaciA<SUP>3</SUP>n y desarrollo, Chile. Grant FONDECYT
dc.fuente.origenWOS
dc.identifier.eissn1535-4970
dc.identifier.issn1073-449X
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/107387
dc.identifier.wosidWOS:000792480406193
dc.information.autorucEscuela de Medicina; Basoalto Escobar, Roque Ignacio; 0000-0002-8908-7397; 1010703
dc.information.autorucEscuela de Medicina; Damiani Rebolledo, Luis Felipe; 0000-0002-8338-0488; 237645
dc.information.autorucEscuela de Medicina; Jalil Contreras, Yorschua Frederick; 0000-0002-4993-7158; 1079709
dc.information.autorucEscuela de Medicina; Carpio Cordero, David Bernardo; 0000-0002-9329-8285; 1015466
dc.information.autorucEscuela de Medicina; Bachmann Barron, María Consuelo; 0000-0002-2006-0591; 215825
dc.information.autorucEscuela de Química; Alegria Aguirre, Luz Katiushka; S/I; 3579
dc.information.autorucEscuela de Medicina; Oviedo Álvarez, Vanessa Andrea; S/I; 1009275
dc.information.autorucEscuela de Medicina; Bugedo Tarraza, Guillermo Jaime; 0000-0001-7527-6202; 60490
dc.information.autorucEscuela de Medicina; Bruhn Cruz, Alejandro Rodrigo; 0000-0001-8034-1937; 741
dc.language.isoen
dc.nota.accesocontenido parcial
dc.revistaAmerican Thoracic Society International Conference Abstracts
dc.rightsacceso restringido
dc.subject.ddc610
dc.titlePhysiologic Effects of High Flow Nasal Cannula Compared to Conventional Oxygen Therapy Postextubation: A Randomized Crossover Study
dc.typecomunicación de congreso
dc.volumen205
sipa.codpersvinculados1010703
sipa.codpersvinculados237645
sipa.codpersvinculados1079709
sipa.codpersvinculados1015466
sipa.codpersvinculados215825
sipa.codpersvinculados3579
sipa.codpersvinculados1009275
sipa.codpersvinculados60490
sipa.codpersvinculados741
sipa.trazabilidadWOS;2022-07-08
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