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고유량 비강 산소 요법 치료의 실패를 응급실 내원 초기에 예측할 수 있는 인자

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Author(s)
은승완김태권전재천최우익진상찬
Publication Year
2018
Keyword
High flow nasal cannulaOxygen therapyRespiratory failure
Abstract
High flow nasal cannula (HFNC) oxygen therapy has become a substitute
for other non-invasive ventilation (NIV) and mechanical ventilation in
patients with respiratory failure. Despite its strong points, HFNC may
result in failure of therapy, and delayed intubation leads to poor patient
outcomes. This study is aimed to identify the variables that predicts HFNC
oxygen therapy failure in order to increment success rate and prevent
delayed intubation. The study was conducted in a retrospective manner,
enrolling all non-traumatic patients over the age 20 who visited a single
university-affiliated tertiary medical center emergency room and were
treated with HFNC between March 1, 2016 to Feburary 28, 2017. Patients
were classified into two groups: HFNC success group, and HFNC failure
group: HFNC failure group was defined as patients who were treated with
HFNC, and resulted in intubation and mechanical ventilation, or death.
General characteristics, clinical features, and laboratory findings of the two
groups were compared. Additionally, univariable logistic regression was
done for statistically significant variables, and if the p -value was <0.05,
multivariable logistic regression analysis was conducted. 95 patients were
enrolled in the study. Repeated-measure ANOVA was conducted for serial
arterial blood gas samples during therapy. 62 patients were successful in
the treatment, and the treatment failed in 33 cases. After multivariate
logistic regression analysis, variable that showed statistically significant
association with HFNC failure was initial hematocrits (p < 0.05).
Repeated-measure ANOVA revealed low bicarbonate as a predictor of
HFNC failure. Predictors of HFNC therapy failure are
initial hematocrits, bicarbonate levels during therapy.
Alternative Title
Early Predictors of High-Flow Nasal Cannula Oxygen Therapy Failure in the
Emergency Room
Department
Dept. of Emergency Medicine (응급의학)
Publisher
Keimyung University School of Medicine
Citation
Keimyung Medical Journal, Vol.37(2) : 66-75-66-75, 2018
Type
Article
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/40363
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