| Objective:To compare the high flow nasal cannula(HFNC)with conventional oxygen therapy(COT)in patients with NYHA ? acute left heart failure(ALHF),and to explore a new innovative therapy.Methods:From November 2018 to November 2019,patients with NYHA III acute left heart failure who met the admission criteria were enrolled in the Affiliated Hospital of Inner Mongolia University of Nationalities.50 patients were randomly divided into treatment group(25 cases)and control group(25 cases).All patients received standard treatment such as diuretics,nitroglycerin,antiplatelet,statins and so on.In the treatment group,high flow oxygen inhalation(HFNC)was used,while in the control group,oxygen was administered via nasal cannula at rate of 2-41/min.The degree of dyspnea and comfort heart rate,respiratory rate,mean arterial pressure(MAP),oxygen saturation,arterial blood gas analysis were measured before and after oxygen inhalation therapy at 6 hours,12 hours,24 hours and 48 hours.The NT-proBNP,cardiac enzyme,Color Doppler echocardiography were measured before and after oxygen inhalation therapy at 12 hours and 48 hours.SPSS 20.0 was used to entry data and analyzed using independent t-test.Results:The mean value of heart rate(HR)on admission and after six hours,twelve hours,twenty four hours and forty eight hours of oxygen inhalation in HFNC and COT group are 98.12±3.21,86.32±2.81,80.96±2.65,76.40±2.94,73.44±3.08 and 97.36±3.48,92.60±3.60,84.96±3.22,82.64±3.54,77.16±2.41 respectively which is statistically significant(P<0.05).The mean value of respiratory rate(RR)on admission and after six hours,twelve hours,twenty four hours and forty eight hours of oxygen inhalation in HFNC and COT group are 31.08±2.58,21.36±2.11,19.24±1.12,17.80±1.10,17.28±0.84 and 30.68±2.68,25.92±1.44,20.96±1.30,21.04±1.13,20.28±1.30 respectively which is statistically significant(P<0.05).The mean value of mean arterial pressure(MAP)on admission and after six hours,twelve hours,twenty four hours and forty eight hours of oxygen inhalation in HFNC and COT group are 100.68±4.79,88.96±3.93,84.56±4.00,80.60±3.16,79.24±2.38 and 102.52±4.67,92.12±4.12,88.20±5.94,84.56±5.06,81.52±3.38 respectively which is statistically significant(P<0.05).The mean value of oxygen saturation(SpO2%)on admission and after six hours,twelve hours,twenty four hours and forty eight hours of oxygen inhalation in HFNC and COT group are 75.32±5.25,90.84±1.59,96.16±1.31,97.04±1.13,97.13±0.97 and 77.60±4.31,87.44±2.93,91.12±1.23,92.32±1.31,93.08±1.03 respectively which is statistically significant(P<0.05).The mean value of partial pressure of arterial oxygen(PaO2 mmhg)on admission and after six hours,twelve hours,twenty four hours and forty eight hours of oxygen inhalation in HFNC and COT group are 52.56±4.16,80.92±5.87,88.60±3.27,91.96±1.98,94.36±1.95 and 56.76±3.55,75.24±4.91,80.68±3.97,83.80±3.77,85.76±3.91 respectively which is statistically significant(P<0.05).The mean value of N-terminal pro B-type natriuretic peptide(NT-proBNP)on admission and twelve hour and forty eight hours of oxygen inhalation in HFNC and COT group are 5318.16±611.78,1714±254.25,1103.04±128.25 and 5183.80±642.47,2028.28±221.23,1658.56±116.73 respectively which is statistically significant(P<0.05).The mean value of CKMB on admission and after twelve hours and forty eight hours of oxygen inhalation in HFNC and COT group are 31.86±12.38,19.84±4.05,17.52±3.1 and 33.80±18.06,24.40±9.60,20.20±3.61 respectively which is statistically significant(P<0.05).The mean value of left ventricular ejection fraction(EF%)on admission and after twelve hours and forty eight hours of oxygen inhalation in HFNC and COT group are 3 7.44±3.3 0,49.52±3.05,55.24±1.39 and 36.92±3.29,44.16±2.88,50.72±2.24 respectively which is statistically significant(P<0.05).The mean value of dyspnea score on admission and after six hours,twelve hours,twenty four hours and forty eight hours of oxygen inhalation with in HFNC and COT group are 4.00±0.50,2.24±0.43,1.96±0.20,1.64±0.49,1.44±0.50 and 4.08±0.40,3.08±0.64,2.28±0.45,2.04±0.53,1.16±0.37 respectively which is statistically significant(P<0.05).Conclusion:In the treatment of patients with acute left heart failure of grade ?,the effect of HFNC on improving oxygenation was significantly better than that of COT,while the effect of HFNC on improving RR,HR,cardiac enzyme index and,six minute walking test and dyspnea was consistent with that of COT.Therefore,hfnc is a new choice in oxygen therapy for patients with NYHA ? acute left heart failure. |
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