Application Of High-flow Nasal Cannula Oxygen Therapy In Elderly Patients With Type Ⅰ Respiratory Failure After Abdominal Surgery Under General Anesthesia

Objective:To investigate the clinical efficacy of HFNC applied to respiratory failure after abdominal surgery in the elderly.Methods:According to the inclusion and exclusion criteria,elderly patients with type Ⅰ respiratory failure after extubation for general anesthesia abdominal surgery admitted to the Department of Intensive Care Medicine of the People’s Hospital of Xinjiang Uygur Autonomous Region from January 2022 to December 2022 were selected;patients meeting the inclusion and exclusion criteria were randomly grouped into HFNC group/NIPPV group by computerized random number table to give ventilatory oxygen therapy.Baseline data were collected separately for the two groups:gender,age,underlying disease,source of abdominal surgery,ASA classification,duration of surgery,APACHE-II score at transfer,SOFA score,duration of mechanical ventilation before extubation,percentage of T-tube off-ramp modalities,and blood gas-related indicators（PaO₂,PaCO₂,ROX index,HR,MAP）before starting oxygen therapy;intermediate observation indicators:use of PaO₂,PaCO₂,ROX index,HR,MAP at 2h,12h,24h and 48h with each oxygen therapy modality,as well as the average number of airway care visits per day during oxygen therapy,nasal and facial pressure sores,abdominal distension and other complications;outcome observation indicators:secondary intubation rate,length of ICU stay,length of hospital stay,in-hospital morbidity and mortality rate of failure of both oxygen therapy modalities in both groups.The data were analysed and processed using SPSS 22.0 statistical software,with P<0.05 indicating a statistically significant difference.Results:A total of 54 patients were included in the study,28 in the HFNC group（18 males）and 26 in the NIPPV group（14 males）.There was no significant difference between the baseline data of the two groups,all P>0.05.There was no significant difference between the two groups in the corresponding time of PaO2,PaCO₂,HR and MAP at 2h,12h,24h and 48h of respective oxygen therapy,all P>0.05.There was no significant difference between the two groups in the corresponding time of ROX index at 2h,12h and 48h of respective oxygen therapy,all P>0.05.The ROX index was significantly better in the HFNC group than in the NIPPV group at 24h of oxygen therapy（11.2±1.6 vs.10.0±1.2,t-value=2.85,P-value=0.006）.There was no difference in the rate of secondary intubation,length of ICU stay,length of hospital stay,in-hospital morbidity and mortality,and failure rate of the two oxygen therapy modalities between the two groups,all P>0.05.Conclusion:Both HFNC and NIPPV were able to There were no differences in the rate of secondary intubation,length of ICU stay,length of hospital stay,in-hospital morbidity and mortality,and failure rate of the two oxygen therapy modalities.