Application Effect Of High Flow Nasal Cannula In Pediatric Severe After The Withdrawal Of Respirator

Objective:Objective:By comparing the support treatment with High Flow Nasal Cannula（HFNC）and Continuous Positive Airway Pressure（CPAP）in the pediatric intensive care unit（PICU）after invasive respirator withdrawal,the application effect of HFNC on the child patients in the PICU after respirator withdrawal was observed to discuss the clinical benefits of HFNC in withdrawn children and better guide the clinical application.Methods:The child patients with invasive respirator to assist in breathing in the First Affiliated Hospital of Xinjiang Medical University during January 2021 to December 2022 were selected as the research objects.One hour before the cannula of the invasive breather pipe,all the respirators for the child patients were withdrawn in strict accordance with the standard withdrawal procedures.By random grouping,they were divided into two groups,33 patients in the observation group and 35 patients in the control group.Both groups received symptomatic respiratory support therapy,while the observation group received HFNC and the control group received CPAP to compared the respiratory rate,arterial partial pressure of carbon dioxide（Pa CO₂）,arterial partial pressure of oxygen（Pa O₂）,oxygenation index and reintubation rate between the two groups,figure out the comfort score after ventilator evacuation and examine the incidence of nasal-sinus barotrauma,abdominal distension,regurgitation and aspiration,and frequent hemorrhoid.Results:1)Comparing arterial Pa O 2 in arterial blood gas after respiratory support in the two groups,it was found that HFNC group>CPAP group[112.18±28.03mm Hg than 99.31±22.70mm Hg（P<0.05）].While comparing the arterial Pa CO₂ contrast,it was revealed that HFNC group>CPAP group[30.69±5.72mm Hg than33.97±3.67mm Hg（P<0.05）].In comparing the respiratory frequency,it was found that HFNC group P>CPAP group[32.03±9.57 times/score ratio 37.29±8.44 times/minute（P<0.05）].In the oxygenation index contrast,HFNC group>CPAP group[274.15±51.28mm Hg than 239.40±65.16mm Hg（P<0.05）].All the differences were statistically significant;2)For the non-invasive failure of re-intubation rate after withdrawal,the rate of the HFNC group（6.1%）was lower than that of the CPAP group（25.7%）with statistically significant difference（P<0.05）.PICU stay period and non-invasive ventilation period of the HFNC group were lower than those of the CPAP group with statistically significant difference（P<0.05）.Meanwhile,the comfort（Ramsay score）was better than that of the CPAP group with statistically significant difference（P<0.05）;3)The complication rate in HFNC group（9.1%）was lower than that of the CPAP group（28.6%）with statistically significant difference（P<0.05）;4)There was no significant difference between the two groups while comparing the gender,age,duration of mechanical ventilation,disease distribution,postoperative status,and trauma status between the two groups,so the differences had no statistically significance（P>0.05）.Conclusion:1)Compared with CPAP,HFNC enhanced oxygenation index,improved oxygen partial pressure（Pa O₂）,reduced respiratory rate and partial pressure of carbon dioxide（Pa CO₂）,showing that it was not inferior to the CPAP group;2)Compared with CPAP,HFNC reduced the reintubation rate,shortened the PICU stay,and had higher comfort and better tolerance than the CPAP group;3)Compared with CPAP,the HFNC group decreased the incidence of complications such as nasal-sinus barotrauma,abdominal distension,regurgitation and aspiration,and frequent hemorrhoid;4)For sequential treatment in children with withdrawal,HFNC is a value priority for respiratory support mode.