High flow nasal oxygen vs. conventional oxygen therapy over respiratory oxygenation index after esophagectomy: an observational study.
| Autor: | Deana C; Anesthesia and Intensive Care Department, Health Integrated Agency of Friuli Centrale, Udine, Italy., Vecchiato M; Department of Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy., Bellocchio F; Department of Medical Area, University of Udine, Udine, Italy., Tullio A; Hygiene and Clinical Epidemiology Unit, Health Integrated Agency of Friuli Centrale, Udine, Italy., Martino A; Department of Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy., Ziccarelli A; Department of Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy., Patruno V; Pulmonology Unit, Cardiothoracic Department, Health Integrated Agency of Friuli Centrale, Udine, Italy., Pascolo M; Department of Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy., Bassi F; Anesthesia and Intensive Care Department, Health Integrated Agency of Friuli Centrale, Udine, Italy., Pontoni M; Pulmonology Unit, Cardiothoracic Department, Health Integrated Agency of Friuli Centrale, Udine, Italy., Raimondi P; Pulmonology Unit, Cardiothoracic Department, Health Integrated Agency of Friuli Centrale, Udine, Italy., Cereser L; Institute of Radiology, Department of Medicine, University of Udine, Udine, Italy., Vetrugno L; Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Chieti, Italy.; Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy., Petri R; Department of Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy., Uzzau A; Department of Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy.; Department of Medical Area, University of Udine, Udine, Italy. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of thoracic disease [J Thorac Dis] 2024 Feb 29; Vol. 16 (2), pp. 997-1008. Date of Electronic Publication: 2024 Feb 04. |
| DOI: | 10.21037/jtd-23-1176 |
| Abstrakt: | Background: Postoperative pulmonary complications after esophagectomy still represent a matter of concern. High flow nasal cannula (HFNC) early after major abdominal and thoracic surgery has demonstrated some advantages over conventional oxygen therapy. Data about respiratory effect of HFNC after esophagectomy is scarce. The primary aim of this study is to investigate if the early use of HFNC after esophagectomy could enhance patients' postoperative respiratory oxygenation (ROX) index and, ultimately, reduce postoperative pneumonia. Methods: In this single center retrospective study all patients undergoing to esophagectomy for cancer from May 2020 to November 2022 were evaluated. Historical cohort (HC) received postoperative oxygen supplementation with Venturi mask or nasal goggles, and a cohort was put under HFNC (HFNC cohort). ROX index, blood gas analysis, radiological atelectasis score (RAS), post-operative complications' data and information on hospital stay have been collected and analyzed. Results: Seventy-one patients were included for the final statistical analysis, 31 in the HFNC and 40 in the HC cohort. Mean age was 64±10 years and body mass index (BMI) was 26 [24-29] kg/m 2 . ROX index was higher in the HFNC patients than in the HC, 20.8 [16.7-25.9] vs. 14.9 [10.8-18.2] (P<0.0001). In the HFNC cohort patients, pH was higher, 7.42 [7.40-7.44] vs. 7.39 [7.37-7.43] than HC, while PaCO Conclusions: HFNC improved the ROX index after esophagectomy through significant respiratory rate reduction. This tool should be considered for early respiratory support after extubation in this category of patients, not only as a rescue therapy for ARF, but also to optimize early postoperative respiratory function. Whether this will improve patients' outcomes requires further large randomized controlled trials. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-1176/coif). The authors have no conflicts of interest to declare. (2024 Journal of Thoracic Disease. All rights reserved.) |
| Databáze: | MEDLINE |
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