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

Other Titles
Early Predictors of High-Flow Nasal Cannula Oxygen Therapy Failure in the Emergency Room
Authors
은승완김태권전재천최우익진상찬
Department
Dept. of Emergency Medicine (응급의학)
Issue Date
2018
Citation
Keimyung Medical Journal, Vol.37(2) : 66-75-66-75, 2018
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.
Keywords
High flow nasal cannulaOxygen therapyRespiratory failure
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/40363
Appears in Collections:
2. Keimyung Medical Journal (계명의대 학술지) > 2018
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학)
Keimyung Author(s)
전재천; 진상찬; 최우익
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