Background: Acute pulmonary edema (APE) is one of the main diagnoses for dyspnea patients in emergency departments (ER). High-velocity nasal cannula (HVNC) might be considered as an alternative support for early management of APE in the ER. Objectives: to compare the effectiveness of HVNC therapy for those with APE to that of conventional oxygen therapy (COT). Methodology: This study was a randomized controlled trial with 60 APE patients admitted to the critical care and chest units at Beni-Suef University Hospital. We randomly assigned patients to Group A, who received COT. Group B received HVNC. All patients received a full history and evaluation, a chest X-ray, and a chest CT scan. A complete blood count (CBC), coagulation profile, renal function tests, and assessments of serum sodium, potassium, and arterial blood gas (ABG) were included in laboratory examinations. We conducted these tests at admission and again six hours later. Results: We linked the use of HVNC to a significant drop in respiratory rate. Both groups' PO2 levels increased while PCO2 decreased. The HVNC intervention was more effective in increasing PO2 and decreasing PCO2 levels than the COT. There was a trend in the HVNC group toward less reliance on mechanical ventilation (MV) as compared to COT. The length of time patients spent in the ICU dropped significantly for those receiving HVNC. Conclusion: In patients with APE, HVNC significantly improves ABG, ICU stay duration, and MV frequency compared to COT. |
- Nicolas Marjanovic, Alexandre Flacher, Loı¨c Drouet, et al: High-Flow Nasal Cannula in Early Emergency Department Management of Acute Hypercapnic Respiratory Failure Due to Cardiogenic Pulmonary Edema. Respir Care 2020;65(9):1241–1249.
- Dong Ryul Ko, Jinho Beom, Hye Sun Lee, et al: Benefits of High-Flow Nasal Cannula Therapy for Acute Pulmonary Edema in Patients with Heart Failure in the Emergency Department: A Prospective Multi-Center Randomized Controlled Trial. J. Clin. Med. 2020, 9, 1937.
- Kemal Şener, Mustafa Çalış, Zikret Köseoğlu, et al: Comparison of high-flow oxygen treatment and standard oxygen treatment in patients with hypertensive pulmonary edema. Anatol J Cardiol 2020; 24: 260-266.
- Panel Pratik Doshi, Jessica S. Whittle, Michael Bublewicz, et al: High-Velocity Nasal Insufflation in the Treatment of Respiratory Failure: A Randomized Clinical Trial. Annals of Emergency Medicine, Volume 72, Issue 1, 2018, 73-83.
- Sarkar M, Madabhavi I, Niranjan N and Dogra M. Auscultation of the respiratory system.. Annals of thoracic medicine.(2014) ; 10 (3): p.158.
- 54- Edward M, Maged SM and Michael JM. Clinical anesthesiology. 4th edition, 2005.
- Doshi P, Whittle JS, Bublewicz M, et al. High-Velocity Nasal Insufflation in the Treatment of Respiratory Failure: A Randomized Clinical Trial. Ann Emerg Med. 2018;72(1):73-83 e75.
- Alberto Domínguez-Rodríguez, Coral Suero-Mendez, Guillermo Burillo-Putze, et al: Midazolam versus morphine in acute cardiogenic pulmonary oedema: results of a multicentre, open-label, randomized controlled trial. European Journal of Heart Failure (2022) 24, 1953–1962.
- Miller TL, Saberi B and Saberi S. Computational fluid dynamics modeling of extra thoracic airway flush: evaluation of high flow nasal cannula design elements. J Pulmon Respir Med. 2016; 6:376.
- Pratik Doshi, Jessica S. Whittle, Michael Bublewicz, et al: High-Velocity Nasal Insufflation in the Treatment of Respiratory Failure: A Randomized Clinical Trial. Ann Emerg Med. 2017; 12:1-11.
- Şener K, Çalış M, Köseoğlu Z, et al: Comparison of high-flow oxygen treatment and standard oxygen treatment in patients with hypertensive pulmonary edema. Anatol J Cardiol. 2020, 24:260-266.
- Onlak Makdee, Apichaya Monsomboon, Usapan Surabenjawong, et al: High-Flow Nasal Cannula Versus Conventional Oxygen Therapy in Emergency Department Patients with Cardiogenic Pulmonary Edema: A Randomized Controlled Trial. Ann Emerg Med. 2017;70:465-472.
- Adhikari P, Bhattarai S, Gupta A, et al: Physiological Effects of High-Flow Nasal Cannula Therapy and Its Use in Acute Cardiogenic Pulmonary Edema. Cureus (2021)13(2): e13372.
- Ko DR, Beom J, Lee HS, You JS and Chung HS, Chung SP: Benefits of high-flow nasal cannula therapy for acute pulmonary edema in patients with heart failure in the emergency department: a prospective multi-center randomized controlled trial. J Clin Med. 2020, 21:1937.
- Nicolas Marjanovic, Alexandre Flacher, Loı¨c Drouet, et al: High-Flow Nasal Cannula in Early Emergency Department Management of Acute Hypercapnic Respiratory Failure Due to Cardiogenic Pulmonary Edema. Respir Care 2020;65(9):1241–1249.
- Bruno L. Ferreyro, Federico Angriman, Laveena Munshi, et al: Association of Noninvasive Oxygenation Strategies with All-Cause Mortality in Adults With Acute Hypoxemic Respiratory Failure A Systematic Review and Meta-analysis. JAMA. 2020; 324(1):57-67.
|