高流量氧疗与标准氧疗对免疫功能低下AHRF患者的生存获益分析

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Abstract Objective To investigate the survival benefit between high flow oxygen therapy and standard flow oxygen therapy for patients with low immune function AHRF. Methods From May 2017 to March 2019, a total of 72 cases in 3 intensive care units of Shanghai General Hospital and Shanghai Oriental Hospital were selected. According to the month of admision, the parity distribution method was adopted, they were divided into the high flow group and the standard flow group, with 36 cases in each group. The high-flow group was provided by oxygen therapy device and the standard flow group was provided by any device or combination of devices. All patients were observed for 28 d. The total mortality of 28 d, the number of deaths in and out of the ICU, the number of invasive ventilation, the number of acquired infections in the ICU, the length of stay in the ICU and the total length of stay in hospital were compared between the two groups. The risk ratio of randomized factor to mortality and cumulative invasive mechanical ventilation rate on 28 d were analyzed. Post-hoc analysis used a model and subset analysis of intubated patients. Results There were no statistically significant differences in terms of total death of 28 d, in and out of ICU death, invasive ventilation, and total hospital stay between the two groups (P > 0.05). The ICU acquired infection in the high flow group was lower than that in the standard flow group, and the length of stay in the ICU was shorter than that in the standard flow group, with statistically significant differences (P < 0.05). Randomization factors had no statistical significance on the mortality rate of 28 d (P > 0.05), and had a statistically significant effect on the cumulative invasive mechanical ventilation rate (P < 0.05). Conclusion Compared with standard flow oxygen therapy, high flow oxygen therapy does not significantly reduce the mortality rate and cumulative invasive mechanical ventilation rate in 28 d, but can improve the oxygenation index (PaO2/FIO2) in a short time, shorten the hospitalization time in ICU and reduce the rate of acquired infection in ICU.

Key words： High flow oxygen therapy Acute hypoxemic respiratory failure Nosocomial acquired infection

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	ZHANG Mingming1 ZHANG Qi1 SHU Qinqin1 WANG Wei2 ZHANG Xing2▲

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ZHANG Mingming1 ZHANG Qi1 SHU Qinqin1 WANG Wei2 ZHANG Xing2▲. Survival benefit analysis of high flow oxygen therapy and standard oxygen therapy for patients with low immune function AHRF[J]. 中国医药导报, 2020, 17(1): 110-114.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I1/110

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