Study On The Effect Of High-Flow Nasal Cannula Oxygen Therapy Combined With Modified Prone Position In Non-Intubated ARDS Patients

Objective:To investigate the effectiveness of High-flow Nasal Cannula oxygen therapy combined with modified prone position in non-intubated ARDS patients.Methods:Seventy-seven patients with ARDS from July 2021 to August 2022 in the intensive care unit of a tertiary care hospital in Xinjiang were selected for the study,including 36 cases in the control group and 41 cases in the experimental group.The control group used non-invasive mechanical ventilation combined with modified prone position method,and the test group used High-flow Nasal Cannula oxygen therapy combined with modified prone position method to treat and care for the patients.The respiratory function indexes,arterial blood gas indexes,intubation rate,hospitalization,overall comfort of treatment,Borg dyspnea score and occurrence of pressure injury were compared between the two groups before,30 min,24 h,48 h and after the end of the intervention.Results:（1）Comparison of respiratory function indexes and arterial blood gas indexes:When comparing the two groups of patients themselves,HR,RR and FiO₂ were lower than before the intervention,and SpO₂,PaO₂ and SaO₂ were higher than before the intervention,and the differences were statistically significant（P<0.05）;repeated-measures ANOVA showed that the differences in time effects between the two groups were statistically significant（P<0.05）.Comparison between groups:after 30 min of intervention,PaO₂ and SaO₂ in the test group were higher than those in the control group,after 48 h of intervention,HR in the test group was higher than that in the control group,and at the end of intervention,SpO₂ and SaO₂ in the test group were higher than those in the control group,and the differences were statistically significant（P<0.05）.（2）The duration of assisted ventilation treatment in the test group was lower than that in the control group;the total duration of modified prone position in the test group was higher than that in the control group,and the difference was statistically significant（P<0.05）.（3）The overall comfort and Borg scores of the test group after the intervention were lower than those of the control group;the overall comfort scores of the control group after the intervention were higher than those before the intervention,and the Borg scores after the intervention were lower than those before the intervention,with statistically significant differences（P<0.05）.（4）The number of cases and the total number of sites of pressure injury in the test group were lower than those in the control group,among which the incidence of pressure injury rate of head and face in the test group was lower than that in the control group,and the difference was statistically significant（P<0.05）.Conclusion:High-flow Nasal Cannula oxygen therapy combined with modified prone position can enhance oxygenation,prolong position maintenance time and improve comfort in non-intubated ARDS patients,reduce the duration of assisted ventilation and the incidence of pressure injury,and alleviate patients’symptoms of dyspnea.