Evaluación del Rendimiento y Producción de Humedad de los Humidificadores de Burbuja usados con Mascarillas Oxígeno de Concentración Variable / Evaluation of the Performance and Humidity Production of Bubble Humidifiers used with Variable Concentration Oxygen Masks

Introducción. Introducción. El uso de humidificadores de burbuja asociados a equipos de oxigenoterapia es una práctica común en los centros hospitalarios de nuestro país. Sin embargo, no se ha evaluado el aporte real de humedad que entregan estos equipos cuando son usados con sistemas de concentración variable a distintas concentraciones de oxígeno. Además, se han descrito problemas de funcionamiento en la entrega de oxígeno cuando se han ocupado este tipo de humidificador. Objetivo. Determinar el aporte real de humedad que entregan los humidificadores de burbuja al ser usados con sistemas de oxigenoterapia de concentración variable. Métodos. Se evaluaron 10 humidificadores de burbuja, marca Hudson RCI®, con válvula liberadora de presión, los cuales se conectaron a un sistema de oxigenoterapia de concentración variable (Marca Hudson RCI®, modelo MULTI-VENT). La medición de la humedad relativa (HR) se realizó en una cámara de acrílico, donde se conectó el inyector del sistema de oxigenoterapia. Para medir H.R. y temperatura se utilizó un higrómetro digital (Veto®, Italia) y un higrómetro análogo (Hygromat®, Alemania). Cada medición requirió un tiempo de 5 minutos para lograr un valor estable. Se realizaron mediciones de la humedad relativa y temperatura entregada por este sistema, con y sin humidificador, a concentraciones de oxígeno de 0.24, 0.26, 0.28, 0.3, 0.35, 0.4 y 0.5. Resultados. Para las la temperatura, no hubo diferencias entre las mediciones realizadas con y sin humidificador de burbuja. Para la humedad relativa, sólo hubo diferencias estadísticamente significativas a concentraciones de oxígeno altas (> 0.35), pero con escaso cambio en la entrega de humedad absoluta. Cuando se utilizó flujos operativos ≥ 6 L/min se activó la válvula liberadora de presión del humidificador. Conclusión. El uso de humidificadores de burbuja asociados a sistemas de oxigenoterapia de concentración variable no genera un aumento significativo de la humedad entregada a concentraciones bajas de oxigeno, por lo cual se podría prescindir de su uso.

Background. The use of bubble humidifiers associated with oxygen therapy equipment is a common practice in hospitals in our country. However, the real contribution of humidity delivered by these equipments when used with variable concentration systems at different oxygen concentrations has not been evaluated. In addition, operating problems have been described in the delivery of oxygen when this type of humidifier has been used. Objetive. Determine the real contribution of humidity delivered by bubble humidifiers when used with variable concentration oxygen therapy systems. Methods. 10 Hudson RCI® brand bubble humidifiers with a pressure release valve were evaluated, which were connected to a variable concentration oxygen therapy system (Hudson RCI® brand, MULTI-VENT model). The relative humidity (RH) was measured in an acrylic chamber, where the injector of the oxygen therapy system was connected. To measure R.H. and temperature, a digital hygrometer (Veto®, Italy) and an analog hygrometer (Hygromat®, Germany) were used. Each measurement required a time of 5 minutes to achieve a stable value. Measurements of the relative humidity and temperature delivered by this system were made, with and without a humidifier, at oxygen concentrations of 0.24, 0.26, 0.28, 0.3, 0.35, 0.4 and 0.5. Results. For temperature, there were no differences between the measurements made with and without a bubble humidifier. For relative humidity, there were only statistically significant differences at high oxygen concentrations (> 0.35), but with little change in absolute humidity delivery. When operating flows ≥ 6 L/min were used, the humidifier pressure relief valve was activated. Conclusion. The use of bubble humidifiers associated with variable concentration oxygen therapy systems does not generate a significant increase in the humidity delivered at low oxygen concentrations, so their use could be dispensed with.

Oxygen therapy and time to upgrade the oxygen therapy / 中国小儿急救医学

Hypoxemia is a common manifestation of many critical illnesses, and oxygen therapy is the most effective treatment for improving hypoxemia.Choosing inappropriate oxygen therapy or delaying the timing of upgrading oxygen therapy may result in persistent cellular and tissue hypoxia, functional impairment, and even organ dysfunction.After starting oxygen therapy, it is necessary to closely observe various indicators such as clinical symptoms, physical signs, pulse oxygen saturation, blood gas analysis, and make full use of various tools such as the respiratory rate oxygenation index, modified respiratory rate oxygenation index, VOX index, L-line diagram model, and online calculators to comprehensively assess the patient′s oxygenation dynamically as well as timely adjust the oxygen therapy mode and parameters to improve patient prognosis.

The effectiveness of closed-loop oxygen therapy for adult non-mechanical ventilation patients: a Meta-analysis / 中国实用护理杂志

Objective:To evaluate the effect of closed-loop therapy system in adult non-mechanical ventilation patients in order to provide evidence-based basis for promoting the safety of oxygen therapy.Methods:Randomized controlled trials of closed-oxygen therapy system on the percentage within SpO 2 target, the incidence of hypoxaemia or hyperoxia, oxygen consumption, the mean oxygen therapy days, as well as the length of hospital stay in adult non-mechanical ventilation patients were searched in PubMed, Web of Science, Embase, Cochrane, CNKI, Wanfang, VIP from inception to June 30, 2022. Data extraction, and literature quality evaluation were performed by two researchers independently, RevMan 5.3 was used for meta-analysis. Results:A total of 5 articles including 502 patients were included. The results showed that the closed oxygen therapy system could significantly improve the percentage of time within SpO 2 target of patients ( SMD=1.56, 95% CI 1.22-1.90, Z=9.04, P<0.001) and reduce the percentage of time with hypoxaemia ( SMD=-0.35, 95% CI-0.50--0.19, Z=4.37, P<0.001) or hyperoxia ( SMD=-0.91, 95% CI-1.07--0.75, Z=11.04, P<0.001) of patients. Moreover, the mean oxygen flow rate of closed oxygen therapy ( SMD=-0.64, 95% CI-1.25--0.03, Z=2.07, P<0.05), the mean oxygen therapy days ( SMD=-0.55, 95%, CI-1.06--0.03, Z=2.08, P<0.05), as well as the length of hospital stay ( SMD=-1.68, 95% CI-2.22--1.14, Z=6.11, P<0.001) were lower than those of patients with manual adjustment systems. Conclusion:The closed oxygen therapy system can promote the safety of oxygen use, but it needs clinical application to further explore.

Applications of different flow rates of humidified high flow nasal cannula oxygen therapy on ICU patients with difficult weaning / 中国实用护理杂志

Objective:To explore the effects of different initial flow rates of humidified high flow nasal cannula oxygen therapy on weaning outcomes and comfort level among ICU patients with difficult weaning.Methods:A total of 99 ICU patients with difficult weaning received at Guangzhou Red Cross Hospital ICU from June 2019 to June 2021 were enrolled in the present study, they were assigned to 40 L/min group, 50 L/min group and 60 L/min group according to the random number table method, with 33 cases in each group. The weaning outcomes among three groups were compared, the degree of dryness of oral/nasal cavity, throat pain as well as vital signs and blood gas indexes were also compared before extubation and 30 min after the first humidified high flow nasal cannula (HHFNC) oxygen therapy.Results:There was no significant difference in length of stay in ICU and hospital, re-intubation within 7 days, the mortality within 28 days in ICU and the hospital among three groups ( P>0.05). The weaning success rate were 78.8% (24/33) and 77.4% (23/31) in 50 L/min group and 60 L/min, higher than in the 40 L/min group 53.1% (17/32), the difference was statistically significant ( χ2=4.78, 4.09, both P<0.05). After oxygen therapy, the scores of dryness of oral/nasal cavity and throat pain in the 40 L/min group, 50 L/min group and 60 L/min group were (3.16 ± 0.77), (2.94 ± 0.80) and (3.27 ± 0.92), (3.09 ± 0.77), and (4.10 ± 1.01), (3.97 ± 1.40), the differences were statistically significant ( F=5.21, 9.26, both P<0.05), and the differences between 50 L/min group and 40 L/min group and 60 L/min group were statistically significant ( t values were 2.62-3.99, all P<0.05). However, there was no significant difference in vital signs and blood gas indexes among the three groups before extubation and after oxygen therapy ( P>0.05). Conclusions:Humidified high flow nasal cannula oxygen therapy for the ICU patients with difficult weaning, oxygen flow with 50L/min can not only effectively promote weaning success rate but also improve patients′ respiratory comfort level.

High-flow nasal cannula oxygen therapy versus non-invasive ventilation for chronic obstructive pulmonary diseases with acute-moderate hypercapnic respiratory failure: a randomized controlled trial of non-inferiority / 中华急诊医学杂志

Objective:To compare the efficacy of high-flow nasal cannula oxygen therapy (HFNC) and non-invasive ventilation (NIV) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with moderate typeⅡ respiratory failure, to clarify the feasibility of HFNC in the treatment of AECOPD, and to explore the influencing factors of HFNC failure.Methods:This study was a randomized controlled trial of non-inferiority. Patients with AECOPD with moderate type Ⅱ respiratory failure [arterial blood gas pH 7.25-7.35, partial pressure of arterial blood carbon dioxide (PaCO 2)> 50 mmHg] admitted to the Intensive Care Unit (ICU) from January 2018 to December 2021 were randomly assigned to the HFNC group and NIV group to receive respiratory support. The primary endpoint was the treatment failure rate. The secondary endpoints were blood gas analysis and vital signs at 1 h, 12 h, and 48 h, total duration of respiratory support, 28-day mortality, comfort score, ICU length of stay, and total length of stay. Multivariate logistic regression analysis was used to evaluate the failure factors of HFNC treatment. Results:Totally 228 patients were randomly divided into two groups, 108 patients in the HFNC group and 110 patients in the NIV group. The treatment failure rate was 29.6% in the HFNC group and 25.5% in the NIV group. The risk difference of failure rate between the two groups was 4.18% (95% CI: -8.27%~16.48%, P=0.490), which was lower than the non-inferiority value of 9%. The most common causes of failure in the HFNC group were carbon dioxide retention and aggravation of respiratory distress, and the most common causes of failure in the NIV group were treatment intolerance and aggravation of respiratory distress. Treatment intolerance in the HFNC group was significantly lower than that in the NIV group (-29.02%, 95% CI -49.52%~-7.49%; P=0.004). After 1 h of treatment, the pH in both groups increased significantly, PaCO 2 decreased significantly and the oxygenation index increased significantly compared with baseline (all P < 0.05). PaCO 2 in both groups decreased gradually at 1 h, 12 h and 48 h after treatment, and the pH gradually increased. The average number of daily airway care interventions and the incidence of nasal and facial lesions in the HFNC group were significantly lower than those in the NIV group ( P < 0.05), while the comfort score in the HFNC group was significantly higher than that in the NIV group ( P=0.021). There was no significant difference between the two groups in the total duration of respiratory support, dyspnea score, ICU length of stay, total length of stay and 28-day mortality (all P > 0.05). Multivariate logistic regression analysis showed that acute physiology and chronic health evaluation Ⅱ score (≥15), family NIV, history of cerebrovascular accident, PaCO 2 (≥60 mmHg) and respiratory rate (≥32 times/min) at 1 h were independent predictors of HFNC failure. Conclusions:HFNC is not inferior to NIV in the treatment of AECOPD complicated with moderate type Ⅱ respiratory failure. HFNC is an ideal choice of respiratory support for patients with NIV intolerance, but clinical application should pay attention to the influencing factors of its treatment failure.

Análisis de la experiencia del uso de cánula nasal de alto flujo como terapéutica en neumonía por SARS-CoV-2 / Analysis of the experience of the use of high-flow nasal cannula as therapeutics in SARS-CoV-2 pneumonia

RESUMEN Introducción: Durante la pandemia por SARS-CoV-2, la cánula nasal de alto flujo (CNAF) se usó como soporte en espera de Unidad de terapia intensiva (UTI) o como alternativa a la ventilación invasiva. Objetivos: Primario: Determinar si la cánula nasal de alto flujo evita la intubación oro traqueal. Secundarios: Analizar predictores de éxito al inicio de la cánula nasal de alto flujo y análisis descriptivo de la muestra. Materiales y métodos: Estudio observacional descriptivo retrospectivo. Se incluyeron pacientes mayores de 16 años positivos para SARS-CoV-2, atendidos en guardia y unidad de terapia intensiva, que utilizaron cánula nasal de alto flujo entre octubre de 2020 y marzo 2021. Se recolectaron datos en planillas individuales, analizadas por un profesional externo. Resultados: Se incluyeron en el trabajo 72 pacientes (de 16 a 88 años), 20 mujeres y 52 hombres. El 50 % de la muestra evitó la intubación orotraqueal. El IROX inicio grupo "éxito" vs. grupo "fracaso", p = 0,006. Comparación Irox 12 h grupo "éxito" vs. grupo "fracaso" p < 0,001. Comparación "tiempo desde ingreso a inicio de cánula nasal de alto flujo" grupo "éxito" vs. grupo "fracaso", p = 0,133. Comparación "Delta IROX" grupo "éxito" vs grupo "fracaso" p = 0,092. Conclusión: Se evitó la intubación orotraqueal en el 50 % de los casos. El IROX de inicio y el IROX a las 12 h del uso de cánula nasal de alto flujo fue estadísticamente significativo, lo que es un buen predictor del éxito en esta población. La fecha de inicio de síntomas y el uso de cánula nasal de alto flujo y el delta del IROX durante las pri meras 12 h no fue estadísticamente significativo para el éxito de la terapia. Estos datos son una herramienta útil con el objeto de generar protocolos de selección de pacientes para esta patología.

ABSTRACT Introduction: During the SARS-CoV-2 pandemic, the high flow nasal cannula (HFNC) was used as support while waiting for the Intensive Care Unit (ICU) or as an alternative to invasive ventilation. The objective of this work is the description and analysis of the use of CNAF in our population. Objectives: Primary: Determine if HFNC prevents orotracheal intubation. Secondary: Analyze predictors of success at the start of CNAF and a descriptive analysis of the sample Materials and method: Retrospective descriptive observational study. Patients over 16 years of age positive for SARS-CoV-2, treated in Guard and ICU were included. who used CNAF between October 2020 and March 2021 Data was collected in individual forms, analyzed by an external professional. Results: The study included 72 patients (16 to 88 years old), 20 women and 52 men; 50 % of the sample avoided orotracheal intubation. Start IROX, group "success" vs. group "failure" p = 0.006. Comparison Irox.12 h group "success" vs. group "failure" p < 0.001. Comparison "Time from admission to start of CNAF" group "success" vs. group "failure" p = 0.133. Comparison "Delta IROX" group "success" vs. group "failure" p = 0.092. Conclusion: HFNC avoided orotracheal intubation in the 50 % of the cases. The initial IROX and the IROX 12 hours after the use of HFNC were statistically significant, which is a good predictor of success in this population. The date of onset of symptoms and the use of FNAF and IROX delta during the first 12 hours were not statistically significant for the success of the therapy. These data are a useful tool for generating patient selection protocols for this pathology.

Evaluation of oxidative stress in an experimental model of Crohn's disease treated with hyperbaric oxygen therapy

Abstract Introduction: Treatments of Inflammatory Bowel Disease (IBD) are able to control symptoms in most cases, however, a fraction of patients do not improve or have a loss of response to treatments, making it important to explore new therapeutic strategies. Hyperbaric oxygen therapy (HBO) may represent one of them. The aim of this study was to evaluate the effects of HBO therapy in an experimental model of IBD. Methods: Sixty male BALBc mice were divided into six groups. Group 1 was colitis-induced with trinitrobenzene sulfonic acid (TNBS) + ethanol, group 2 received TNBS + ethanol plus HBO, group 3 received only ethanol, group 4 received ethanol plus HBO, group 5 received saline solution, and group 6 received saline solution plus HBO. HBO was performed for four days, subsequently, the mice were evaluated daily. At the end of the study, samples from the intestine were collected for histological analysis as well as for measurement of antioxidant enzymes and cytokine levels. Results: HBO significantly improved the clinical and histological status of the animals. Treatment with HBO increased the activity of the antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx) in all of the groups; moreover, the difference was only significant between the TNBS and TNBS + HBO groups and treatments promoted a reduction in the proinflammatory cytokines IFN-γ, IL-12, IL-17 and TNF-α and increased the anti-inflammatory cytokines IL-4 and IL-10, with no changes in IL-13. Conclusion: HBO effectively treats TNBS-induced colitis by increasing the activity of antioxidant enzymes and modulating cytokine profiles.

Effect of hyperbaric oxygen therapy combined with repetitive peripheral magnetic stimulation on ankle motor function and balance of stroke patients / 中国康复理论与实践

ObjectiveTo observe the effect of hyperbaric oxygen therapy (HBOT) combined with repetitive peripheral magnetic stimulation (rPMS) on ankle motor function and balance of stroke patients. MethodsFrom April, 2022 to March, 2023, 96 patients in the First Affiliated Hospital of Bengbu Medical College were randomly divided into control group (n = 32), rPMS group (n = 32) and combined group (n = 32). The control group received conventional rehabilitation; rPMS group received rPMS on the basis of the control group; and the combined group received HBOT on the basis of rPMS group, for two weeks. Before and after treatment, the plantar weight-bearing ratio of the affected side, Berg Balance Scale (BBS), active range of motion (AROM) of ankle dorsiflexion of the affected side, and integrated electromyographic (iEMG) values during maximum isometric contraction of the tibialis anterior and gastrocnemius muscles were measured. ResultsTwo cases dropped out in each group, and 90 cases were finally included, and no adverse events occurred during treatment. Before treatment, there was no significant difference in plantar weight-bearing ratio of the affected side, BBS score, AROM of ankle dorsiflexion of the affected side, and iEMG of tibialis anterior and gastrocnemius among three groups (F < 2.070, P > 0.05). After treatment, all the indicators significantly improved in all the groups (|t| > 27.004, P < 0.001), and they were better in the combined group than in rPMS group and the control group (P < 0.001); except the proportion of plantar weight-bearing on the affected side, the other indicators were better in rPMS group than in the control group (P < 0.001). ConclusionrPMS can promote the recovery of ankle motor function and balance of stroke patients, and the effect combining with HBOT is better.

Early clinical application and prediction of ROX index in patients with high-flow nasal canula oxygen therapy / 中华危重病急救医学

Objective:To investigate the application value of ROX index in evaluating the effect of high-flow nasal cannula oxygen therapy (HFNC) on patients diagnosed with respiratory failure, and to find a simpler and more effective method to observe the efficacy of HFNC.Methods:A retrospective cohort study was conducted. Patients who were admitted to department of critical care medicine of the Tianjin Third Central Hospital from April 2020 to August 2022, diagnosed with type Ⅰ respiratory failure, and treated with HFNC after failure of conventional oxygen therapy were enrolled. Oxygenation index (PaO 2/FiO 2), fraction of inspired oxygen (FiO 2), gas flow rate at the initial time of admission, and pulse oxygen saturation (SpO 2), FiO 2 and respiratory rate (RR) at 2, 4, 6, 8, 10 and 12 hours of HFNC were collected, and ROX index was calculated. The patients with symptoms and PaO 2/FiO 2 improved after HFNC treatment and without higher respiratory support lately were defined as HFNC success, while other patients with symptoms worsening and needing follow-up non-invasive positive pressure ventilation (NIPPV) or invasive positive pressure ventilation (IPPV) were defined as HFNC failure. The tendency of changes in the ROX index at each time point was observed. Receiver operator characteristic curve (ROC curve) was plotted to obtain the optimum cut-off value of ROX index for predicting HFNC outcome and the optimal monitoring time point for HFNC. Results:A total of 142 patients were eventually enrolled, among whom 96 patients (67.61%) were in treated with HFNC successfully, while 46 patients (32.39%) were recorded as HFNC failure (39 patients and 7 patients received NIPPV or IPPV, respectively), with an overall intubation rate of 4.93% (7/142). Compared with the HFNC success group, the HFNC failure group had lower PaO 2/FiO 2 [mmHg (1 mmHg ≈ 0.133 kPa): 208.8±37.3 vs. 235.7±48.3, P < 0.01] and higher initial gas flow rate (L/min: 46.4±3.9 vs. 42.3±4.9, P < 0.01). However, there was no significant difference in gender, age, primary diagnosis, severity of disease, hemoglobin (Hb), C-reactive protein (CRP), and brain natriuretic peptide (BNP) between the two groups. In the HFNC failure group, there were 12 patients (26.09%) received progressive oxygen therapy within 12 hours of HFNC, of which 3 patients (6.52%) occurred within 6 hours, while the other 9 patients (19.57%) occurred after 6 hours. The initial ROX index was not statistically significant between the two groups. Both groups showed a continuous increasing ROX index with longer treatment duration of HFNC, and the ROX index at all of the time points of the HFNC failure group was significantly lower than that of the HFNC success group with statistically significant difference (2 hours: 9.39±2.85 vs. 10.91±3.51, 4 hours: 8.62±2.29 vs. 11.40±3.18, 6 hours: 7.62±1.65 vs. 11.85±3.45, 8 hours: 7.79±1.59 vs. 11.62±3.10, 10 hours: 7.97±1.62 vs. 12.44±2.75, 12 hours: 8.84±2.51 vs. 12.45±3.03, all P < 0.05). The ROC curve analysis showed that the areas under the ROC curve (AUC) of ROX index assessing the effect of HFNC at the time of treating 6, 8 and 10 hours were better than 2, 4 and 12 hours (0.890, 0.903, 0.930 vs. 0.585, 0.738 and 0.829), indicating that the ROX index could determine the efficacy at the early stage of HFNC (within 6 hours). When the optimum cut-off value of ROX index was 8.78, the sensitivity was 90.6%, and the specificity was 76.5%. Conclusion:The ROX index at 6 hours of HFNC has a certain predictive value for the efficacy of HFNC with an optimum cut-off value of 8.78, which can provide clinical health care personnel a method for observing the efficacy of HFNC, and guide the correct selection of oxygen therapy modality at an early stage and timely adjustment of oxygen therapy strategy.

Administración de Oxigenoterapia de Alto Flujo en pacientes pediátricos del Hospital de Niños Santísima Trinidad / Administration of High Flow Oxygen Therapy in pediatric patients of the Santísima Trinidad Children's Hospital

La manera de proveer oxígeno ha sido una idea en permanente evolución que ha gatillado en los médicos la inquietud de implementar distintos dispositivos de soporte, desde la cánula nasal, la máscara de reinhalación y bajo flujo, hasta la presión continua en la vía aérea (CPAP) y la ventilación no invasiva (VNI). Recientemente se ha insertado entre ambos extremos mencionados un nuevo dispositivo que provee oxígeno a alto flujo. El objetivo del presente trabajo fue describir aspectos clínicos y técnicos en la administración de Oxigenoterapia de Alto Flujo (OAF) en pacientes pediátricos del Hospital de Niños de la Santísima Trinidad, en el servicio de UEPE (Unidad estabilización pediátrica en emergencia) 2017 y SIP (sala de internación pediátrica) 500 2018, 2019, en el periodo estival. Se realizó un Estudio descriptivo transversal, retrospectivo. El universo fueron los pacientes pediátricos que recibieron OAF en el Hospital de Niños Santísima Trinidad, en el servicio de UEPE del 2017 y SIP 500 2018, 2019 en el periodo estival. Se utilizó como instrumento la tabla de volcado de datos. Los principales resultados demuestran que se asistieron un total de 697 pacientes. La edad prevalente fue de menores de 6 meses, con un promedio del 60%. Los niños que requerían este tratamiento, en su gran mayoría ingresaban por diagnóstico de bronquiolitis, seguido de BOR (bronquitis obstructiva recurrente).En relación al escore de tal modifcado al ingreso, podemos observar que en el sector de UEPE la media es de 8, mientras que la SIP 500 es de 7. En referente al recurso material, existen varios sistemas de OAF. No hay estudios que demuestren la superioridad de un sistema sobre otro.Por último, se observó que el haber implementado esta técnica en la institución, se logró evitar en gran numero la escalada ventilatoria máxima requerida, ya que en el servicio de UEPE la evolución fue 65% la OAF, mientras que en la SIP 500 en el 2018 fue 72%y en el 2019 fue 79%. Por lo que podemos establecer que la OAF logra una mejoría clínica a través de su impacto en el síndrome funcional respiratorio, así como en el score de Tal modifcado en los niños y permite un tratamiento de estos pacientes en salas de internado general, con mínimos efectos adversos, disminuyendo el ingreso a cuidados intensivos[AU]

Te way to provide oxygen has been an idea in constant evolution that has triggered in doctors the concern to implement different support devices, from the nasal cannula, the rebreathing mask and low flow, to continuous pressure in the airway (CPAP). ) and noninvasive ventilation (NIV). Recently, a new device that provides high-flow oxygen has been inserted between both extremes. Te objective of the present work was to describe clinical and technical aspects in the administration of High Flow Oxygen Terapy (OAF) in pediatric patients of the Santísima Trinidad Children's Hospital, in the UEPE service (Emergency Pediatric Stabilization Unit) 2017 and SIP ( pediatric hospitalization room) 500 2018, 2019, in the summer period. A retrospective cross-sectional descriptive study was carried out. Te universe was the pediatric patients who received HFO at the Santísima Trinidad Children's Hospital, in the UEPE service in 2017 and SIP 500 2018, 2019 in the summer period. Te data dump table was used as an instrument. Te main results show that a total of 697 patients were attended. Te prevalent age was under 6 months, with an average of 60%. Te vast majority of children who required this treatment were admitted due to a diagnosis of bronchiolitis, followed by BOR (recurrent obstructive bronchitis). In relation to the score of such modifed on admission, we can observe that in the UEPE sector the mean is 8, while the SIP 500 is 7. Regarding the material resource, there are several OAF systems. Tere are no studies that demonstrate the superiority of one system over another. Finally, it was observed that having implemented this technique in the institution, the maximum required ventilatory escalation was avoided in large numbers, since in the UEPE service the evolution was 65% of the OAF, while in the SIP 500 in 2018 it was 72% and in 2019 it was 79%. Terefore, we can establish that HFO achieves clinical improvement through its impact on functional respiratory syndrome, as well as on the modifed Tal score in children, and allows treatment of these patients in general hospital wards, with minimal effects. adverse effects, reducing admission to intensive care[AU]

A forma de fornecer oxigênio tem sido uma ideia em constante evolução que desencadeou nos médicos a preocupação em implementar diferentes dispositivos de suporte, desde a cânula nasal, a máscara de reinalação e baixo fluxo, até a pressão contínua nas vias aéreas (CPAP). ) -ventilação invasiva (VNI). Recentemente, um novo dispositivo que fornece oxigênio de alto fluxo foi inserido entre os dois extremos. O objetivo do presente trabalho foi descrever aspectos clínicos e técnicos na administração de Oxigenoterapia de Alto Fluxo (OAF) em pacientes pediátricos do Hospital Infantil Santísima Trinidad, no serviço UEPE (Unidade de Emergência Pediátrica de Estabilização) 2017 e SIP (internação pediátrica quarto) 500 2018, 2019, no período de verão. Foi realizado um estudo descritivo transversal retrospectivo. O universo foram os pacientes pediátricos que receberam HFO no Hospital Infantil Santísima Trinidad, no serviço da UEPE em 2017 e SIP 500 2018, 2019 no período de verão. A tabela de despejo de dados foi utilizada como instrumento. Os principais resultados mostram que foram atendidos um total de 697 pacientes, sendo a idade prevalente inferior a 6 meses, com média de 60%. A grande maioria das crianças que necessitaram desse tratamento foi internada por diagnóstico de bronquiolite, seguido de BOR (bronquite obstrutiva recorrente). Em relação ao escore desta modifcada na admissão, observa-se que no setor da UEPE a média é 8 , enquanto o SIP 500 é 7. Em relação ao recurso material, existem vários sistemas OAF. Não há estudos que demonstrem a superioridade de um sistema sobre o outro. Por fm, observou-se que com a implantação dessa técnica na instituição, evitou-se em grande número o escalonamento ventilatório máximo necessário, pois no serviço da UEPE a evolução foi de 65% de na OAF, enquanto no SIP 500 em 2018 foi de 72% e em 2019 foi de 79%. Portanto, podemos estabelecer que a HFO obtém melhora clínica por meio de seu impacto na síndrome respiratória funcional, bem como no escore de Tal modifcado em crianças, e permite o tratamento desses pacientes em enfermarias de hospital geral, com efeitos mínimos. tratamento intensivo[AU]

Terapia de alto flujo ¿Una alternativa en rehabilitación? / High flow therapy: An option to rehabilitation?

La pandemia por el virus SARS-COV2 que causó la enfermedad COVID-19 ha traído grandes desafíos al sistema de salud tanto a nivel nacional como mundial. En Chile, gracias al esfuerzo de organismos gubernamentales e instituciones privadas, los centros de salud se han equipado con distintos dispositivos de terapia ventilatoria (ventilación mecánica invasiva y no invasiva, y terapia de alto flujo de oxígeno mediante cánula nasal (TAF) con la finalidad de abarcar mayor atención de pacientes tras un periodo de crisis sanitaria que colapsó las redes de atención secundaria y terciaria de salud. En concordancia a esto, es interesante evaluar qué utilidad puede darse a estos equipos posterior a la pandemia, considerando que en varios centros de salud se duplicó o triplicó la disponibilidad de recursos técnicos. En este contexto, la TAF entrega efectos fisiológicos favorables y útiles en escenarios clínicos que implican aumento de las demandas ventilatorias, no sólo en condiciones de insuficiencia respiratoria hipoxémica aguda, sino en condiciones en donde el ejercicio aeróbico es un pilar fundamental, como es el caso de los diferentes programas de rehabilitación (cardiovascular, respiratorio, metabólico, etc.) incluidos como Garantías Explícitas de Salud (GES). Así, la incorporación de TAF en la rehabilitación pulmonar sería una opción adecuada en pacientes con disfunciones respiratorias crónicas, ampliando la cobertura sanitaria que estos programas tienen hoy en día.

The SARS-COV2 pandemic that caused the COVID-19 disease has brought significant challenges to the health system nationally and globally. In Chile, thanks to the efforts of government agencies and private institutions, health centres have been equipped with di-fferent ventilatory therapy devices (invasive and non-invasive mechanical ventilation, and high-flow oxygen therapy by nasal cannula (HFOT)), in order to cover more patient care after a period of a health crisis that collapsed secondary and tertiary health care networks. Accordingly, it is interesting to evaluate concerning what use can be given to these teams after the pandemic, even more considering that the availability of technical resources doubled or tripled in several health centres. In this context, HFOT provides favourable and useful physiological effects in clinical scenarios that involve increased ventilatory demands, not only in conditions of acute hypoxemic respiratory failure but also in conditions where aerobic exercise is a fundamental pillar, as is the case of the different rehabilitation programs (cardiovascular, respiratory, metabolic, etc.) included as Health Guarantees (Garantías Explicitas en Salud, GES). Thus, incorporating HFOT in pulmonary rehabilitation would be an appropriate option in patients with chronic respiratory dysfunctions, expanding the health coverage that these programs have today.

Impact of Moderate Altitude on Lung Diseases and Risk of High Altitude Illnesses

ABSTRACT A large world population resides at moderate altitudes. In the Valley of Mexico (2240 m above sea level) and for patients with respiratory diseases implies more hypoxemia and clinical deterioration, unless supplementary oxygen is prescribed or patients move to sea level. A group of individuals residing at 2500 or more meters above sea level may develop acute or chronic mountain disease but those conditions may develop at moderate altitudes although less frequently and in predisposed individuals. In the valley of México, at 2200 m above sea level, re-entry pulmonary edema has been reported. The frequency of other altitude-related diseases at moderate altitude, described in skiing resorts, remains to be known in visitors to Mexico City and other cities at similar or higher altitudes. Residents of moderate altitudes inhale deeply the city's air with all pollutants and require more often supplementary oxygen.

Usos de cámara hiperbárica en otorrinolaringología / Uses for hyperbaric chambers in otolaryngology

Resumen En la terapia con oxígeno hiperbárico (HBO) se utiliza oxígeno al 100% de concentración en una cámara presurizada con presiones supraatmosféricas, que corresponden de 2 a 3 atmósferas. Los mecanismos por los cuales funciona esta terapia se relacionan con propiedades físicas de los gases y su comportamiento fisiológico en el organismo, lo que lleva finalmente a la hiperoxia, evento fisiológico que permite la obtención de diversos efectos beneficiosos. La evidencia en medicina ha demostrado su utilidad mayormente en la enfermedad por descompresión, infecciones cutáneas graves e intoxicación por monóxido de carbono. En el ámbito de la otorrinolaringología ha probado ser útil en algunas enfermedades como la hipoacusia súbita idiopática, tanto como terapia única como asociada al uso de corticosteroides, como en la osteomielitis refractaria del oído externo, la que en conjunto con antibioticoterapia y manejo quirúrgico presenta un evidente aumento en la tasa de mejoría. Cabe mencionar que la terapia con HBO ha demostrado también beneficios en los tratamientos y complicaciones posteriores a la radiación en pacientes con cáncer de cabeza y cuello. Es importante mencionar que la terapia con HBO no está exenta de riesgos y requiere que los pacientes cumplan con características específicas para su utilización, por lo que su indicación debe ser juiciosa y en casos seleccionados.

Abstract In hyperbaric oxygen therapy, 100% pure oxygen is used in a pressurized chamber with super atmospheric pressures which correspond to 2-3 atmospheres. The mechanism by which this treatment works is related to the physical properties of gases and their physiological behavior in the body, which leads to hyperoxia, the physiological event which allows for diverse beneficial health effects. The evidence in medicine has proven its utility mainly in decompression sickness, severe skin infections and carbon monoxide poisoning. In the otolaryngology field it has been proven useful in diseases like idiopathic sudden sensorineural hearing loss, both as the only treatment and as a concurrent treatment along with corticosteroids, in malignant otitis externa which in conjunction with antibiotic treatment and a surgical approach presents a clear increase in improvement rates. It must be mentioned that hyperbaric chamber treatment has also shown benefits in radiation treatment and post radiation complications in head and neck cancer patients. It is important to note that hyperbaric oxygen therapy is not without risks and patients must meet specific criteria for it to be applied, therefore it must be indicated using careful judgement and only in necessary cases.

An emerging role of platelet-rich plasma and hyperbaric oxygen in the management of inclusion body myositis: a case report

Inclusion body myositis is an uncommon inflammatory myopathy that causes progressive muscle weakness. Patient management includes immunosuppressant therapy and nonpharmacologic therapies, like physical, occupational, and speech therapy. Standard treatment plans focus on the maintenance of muscle strength and function. Many patients do not respond to pharmacologic therapies and due to the progressive nature of this myopathy,patients eventually become debilitated. Hyperbaric oxygen therapy and platelet-rich plasma injections were provided as adjunctive therapy to a 70-year-old female patient with inclusion body myositis. After treatment, she had improvement in her muscle function and improved ambulation. This case study highlights the impact of adjunctive therapy in a patient with inclusion body myositis.

A description of patients hospitalized in a quaternary care institution with cardiovascular disease and the need for continuous home oxygen therapy / Caracterización de los pacientes hospitalizados con enfermedad cardiovascular y requerimiento de oxigenoterapia continua domiciliaria en una institución de IV nivel de atención

Abstract Continuous home oxygen therapy (CHOT) is a widely used intervention but has scant evidence regarding its indications, benefits and the clinical predictors which could affect its requirement in patients with cardiovascular disease. Objective: to describe the patients with cardiovascular disease and the need for home oxygen therapy at the Fundación Cardioinfantil throughout 2018. Methods: a descriptive observational study. Hospitalized patients at Fundación Cardioinfantil from January 1, 2018, to December 31, 2018, diagnosed with cardiovascular disease and presenting their first request for home oxygen. Sociodemographic, clinical, laboratory, and imaging variables along with inpatient days and length of stay in the ICU, were collected. Results: 192 patients were studied. The median age was 74 years (IQR: 64, 25 - 81). The BMI was 25.98 kg/m2 (IQR: 22.74 - 29.67). A total of 47.9% of the population had coronary disease; 49.5% had heart failure; 27.1% had PH, 23% had OSAH, 6.3% had PTE and 16.7% had COPD. The average BNP was 1,430 SD 1,302. The average LVEF was 35.43% SD 15.35 and the median PASP was 53 mmHg (IQR 43 - 65). Altogether, 71.9% required ICU treatment. The average hospital stay was 14.08 days SD 10.1 days. A total of 20.8% of the patients had a PaO2 less than 55 mmHg; 77.1% belonged to the contributive social security regimen. Conclusions: we found that only a minority of the study patients for whom CHOT was ordered met the usually accepted criteria. Half of the patients had heart failure, most with reduced LVEF and elevated BNP, criteria which are not currently used for prescribing CHOT. More studies should be performed on the indications for supplementary oxygen therapy in this population. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2207).

Resumen La oxigenoterapia domiciliaria continua (OCD) es una intervención altamente utilizada, pero con escasa evidencia sobre sus indicaciones, beneficios y predictores clínicos que puedan influir sobre su requerimiento en pacientes con enfermedad cardiovascular. Objetivo: caracterizar los pacientes con enfermedad cardiovascular y requerimientos de oxígeno domiciliario hospitalizados en la Fundación Cardioinfantil durante el año 2018. Métodos: estudio observacional descriptivo, hospitalizados en la Fundación Cardioinfantil del 1° de enero del 2018 a 31 de diciembre del 2018 con diagnóstico de enfermedad cardiovascular y con primera solicitud de oxígeno domiciliario. Se tomaron variables sociodemográficas, clínicas, paraclínicas, imagenológicas, días de hospitalización y estancia de UCI. Resultados: se estudiaron 192 pacientes. La mediana de edad fue 74 años (RIQ: 64, 25-81). El IMC fue 25.98 Kg/m2 (RIQ: 22.74-29.67). El 47.9% de la población tenía enfermedad coronaria. El 49.5% de los pacientes presentaban falla cardiaca. El 27.1% tenía HTP, 23% SAHOS, 6.3% TEP y 16.7% EPOC. El promedio del BNP fue de 1430 DS 1302. La FEVI promedio fue de 35.43% DS 15.35 y la mediana PSAP fue de 53 mmHg (RIQ 43-65). El 71.9% requirió manejo en UCI. El promedio de estancia hospitalaria fue de 14.08 días DS 10.1 días. El 20.8% de los pacientes tenían una PaO2 menor a 55mmHg. El 77.1% pertenecían al régimen contributivo. Conclusiones: encontramos que sólo una minoría de pacientes estudiados a los que se le indicó OCD cumplían con los criterios actualmente aceptados. La mitad de los pacientes presentaban falla cardiaca, la mayoría con FEVI reducida y BNP elevado, criterios que actualmente no son utilizados para la prescripción de OCD. Se deben realizar más estudios sobre indicaciones de la terapia con oxígeno suplementario en esta población. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2207).

Effect of liberal or conservative oxygen therapy on the prognosis for mechanically ventilated intensive care unit patients: a meta-analysis

ABSTRACT BACKGROUND: For critically ill patients, physicians tend to administer sufficient or even excessive oxygen to maintain oxygen saturation at a high level. However, the credibility of the evidence for this practice is unclear. OBJECTIVE: To determine the effects of different oxygen therapy strategies on the outcomes of mechanically ventilated intensive care unit (ICU) patients. DESIGN AND SETTING: Systematic review of the literature and meta-analysis conducted at Jiangxi Provincial People's Hospital, Affiliated to Nanchang University, Nanchang, China. METHODS: We systematically searched electronic databases such as PubMed and Embase for relevant articles and performed meta-analyses on the effects of different oxygen therapy strategies on the outcomes of mechanically ventilated ICU patients. RESULTS: A total of 1802 patients from five studies were included. There were equal numbers of patients in the conservative and liberal groups (n = 910 in each group). There was no significant difference between the conservative and liberal groups with regard to 28-day mortality (risk ratio, RR = 0.88; 95% confidence interval, CI = 0.59-1.32; P = 0.55; I2 = 63%). Ninety-day mortality, infection rates, ICU length of stay, mechanical ventilation-free days up to day 28 and vasopressor-free days up to day 28 were comparable between the two strategies. CONCLUSIONS: It is not necessary to use liberal oxygen therapy strategies to pursue a higher level of peripheral oxygen saturation for mechanically ventilated ICU patients. Conservative oxygen therapy was not associated with any statistically significant reduction in mortality.

EFFECTS OF HYPERBARIC OXYGEN THERAPY IN PATIENT WITH ACUTE UPPER LIMB FINGER GANGRENE WITH COVID-19

The COVID-19 pandemic (Corona Virus Diseas) was caused by a new beta coronavirus in early 2020, also called Severe Acute Respiratory Syndrome (SARS-CoV-2). Predilection sites of virus entry are the lungs, intestines, blood vessels, kidney, and adipose tissue cells are the virus reservoir. The virus causes a violent reaction of in?ammatory cytokines - cytokine storm, activation of coagulation and formation of thrombin. The initial coagulopathy of COVID-19 is manifested by a pronounced disorder of D-dimer and ?brin/?brinogen degradation products, while abnormalities in prothrombin time, partial thromboplastin time and platelet count are relatively rare at the onset of the disease. Later, the phenomenon of thrombotic microangiopathy occurs, which is a consequence of in?ammation of the blood vessels endothelium. In severe cases of infection, thromboembolism or acute thrombosis of peripheral blood vessels may occur. The paper presents a case of a patient with COVID-19 infection in whom, in addition to the usual clinical picture of the disease with changes in lung parenchyma (bilateral pneumonia), thrombosis of the a. radialis and a. ulnaris of the left hand developed, and ?fteen days after the infection development, the development of gangrene of the distal articles II, III and IV of the ?nger occurs. In addition to therapy used according to the national guide to COVID-19, hyperbaric oxygen therapy (HBOT) was used. The effect of this therapy was used to increase vascular permeability and create factors that affect angiogenesis and improve blood ?ow in the ischemic region. HBOT also affected the demarcation of necrotic from healthy tissue, and stimulated wound healing. After two sessions of HBOT treatment, there was a complete restitution of blood ?ow with full function of the left hand and all its ?ngers.

Medium-pressure hyperbaric oxygen therapy for livedoid vasculopathy / Terapia de oxigenación hiperbárica de media presión en vasculopatía livedoide

Abstract Livedoid vasculopathy (LV) is a cutaneous manifestation of several diseases that lead to non-inflammatory thrombosis of dermal vessels. We report the case of a 26-year-old female with a 4 years and 8 months-old history of diagnosis of LV and a non-healing ulcer of more than a year of evolution. Because of refractory response to standard care, low-pressure hyperbaric oxygen (LPHBOT) was added to the therapeutic scheme (azathiopine 2.5 mg/kg, folic acid and acetylsalicylic acid). After 12 sessions of LHBOT (60 min, 1.45 ATA ≈100% O2), ulcers achieved complete healing with significant pain relief and no recurrence was present over 6 months. More studies are necessary to determine the effectiveness of HBOT for LV treatment.

Resumen La vasculopatía livedoide (VL) es una manifestación cutánea de varias enfermedades que conducen a una trom bosis no inflamatoria de los vasos dérmicos. Se presenta el caso de una mujer de 26 años con antecedente de diagnóstico de vasculopatía livedoide de 4 años y 8 meses, además de una úlcera no cicatrizante de más de un año de evolución. Debido a la respuesta refractaria a la atención estándar, se añadió oxígeno hiperbárico a baja presión (LPHBOT) al esquema terapéutico (azatriopina 2.5 mg/kg, ácido fólico y ácido acetilsalicílico). Después de 12 sesiones de LHBOT (60 min, 1,45 ATA ≈100% O2), las úlceras tuvieron una curación completa con un alivio significativo del dolor y no hubo recurrencia durante 16 meses. Se necesitan más estudios para determinar la eficacia de TOHB para el tratamiento del VL.

Fatores associados ao uso de oxigenoterapia e suporte ventilatório em recém-nascidos prematuros / Factors associated with the use of oxygen therapy and ventilatory support in premature newborns

INTRODUÇÃO: A terapia com oxigênio suplementar reduz quadros de hipóxia, diminuindo a mortalidade entre recémnascidos prematuros (RNPT), porém a excessiva exposição ao oxigênio tem o potencial de atingir e danificar múltiplos órgãos do neonato. OBJETIVO: Determinar os fatores associados ao uso de suporte ventilatório/oxigenoterapia nos RNPT. MATERIAIS E MÉTODOS: Estudo observacional, longitudinal, prospectivo de caráter quantitativo, realizado no período de julho de 2019 a março de 2020, em unidade de terapia intensiva neonatal (UTIN) de um hospital público universitário. Foram observados RNPT em uso de oxigenoterapia, desde o período de admissão até a alta, sendo coletados dados gestacionais, de nascimento e parâmetros da oxigenoterapia. RESULTADOS: 62 RNPT foram acompanhados com média de idade gestacional (IG) de 30,5 semanas (±3,43) e mediana de peso ao nascimento (PN) de 1.390 gramas (555 g - 3.115 g). O tempo médio de internação de 35 dias (3-176) e de oxigenoterapia foi de 7,5 dias (1-176). Ao relacionar o total de dias em oxigenoterapia com o valor do Apgar no 5º minuto, não houve relação significativa (rho= -0,158; p=0,219), porém, houve relação com a IG ao nascimento (rho= -0,725; p<0,001), uso de corticoide antenal (p=0,006) e surfactante exógeno (<0,001). Houve relação também com displasia broncopulmonar (DBP) e retinopatia da prematuridade (ROP) (p<0,001). CONCLUSÃO: Os fatores associados ao tempo e uso de oxigenoterapia foram a IG, PN, uso de corticoide antenal e surfactante exógeno, sendo observado também associação com DBP e ROP.

INTRODUCTION: Supplemental oxygen therapy reduces hypoxia by reducing mortality among preterm newborns (PTNBs), but excessive exposure to oxygen has the potential to affect and damage multiple organs of the newborn. OBJECTIVE: To determine the factors associated with the use of ventilatory support/oxygen therapy in PTNBs. MATERIALS AND METHODS: This is an observational, longitudinal, prospective quantitative study, conducted from July 2019 to March 2020, in a neonatal intensive care unit (NICU) of a public university hospital. PTNBs on oxygen therapy were observed from the time of admission to discharge, and gestational data, birth data and oxygen therapy parameters were collected. RESULTS: 62 PTNs were followed with a mean gestational age (GA) of 30.5 weeks (±3.43) and median birth weight (BW) of 1,390 grams (555 g - 3,115 g). The mean hospital stay of 35 days (3-176) and oxygen therapy was 7.5 days (1-176). When relating the total days in oxygen therapy with the value of Apgar at the 5th minute, there was no significant relationship (rho= -0.158; p=0.219), however, there was a relationship with GA at birth (rho= -0.725; p<0.001), use of antenal corticosteroids (p=0.006) and exogenous surfactant (<0.001). There was also a relationship with bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) (p<0.001). CONCLUSION: The factors associated with time and use of oxygen therapy were GA, BW, use of antenal corticosteroids and exogenous surfactant, and association with BPD and ROP was also observed.

[Errata] Fatores associados ao uso de oxigenoterapia e suporte ventilatório em recém-nascidos prematuros / [Erratum] Factors associated with the use of oxygen therapy and ventilatory support in premature newborns

INTRODUÇÃO: A terapia com oxigênio suplementar reduz quadros de hipóxia, diminuindo a mortalidade entre recémnascidos prematuros (RNPT), porém a excessiva exposição ao oxigênio tem o potencial de atingir e danificar múltiplos órgãos do neonato. OBJETIVO: Determinar os fatores associados ao uso de suporte ventilatório/oxigenoterapia nos RNPT. MATERIAIS E MÉTODOS: Estudo observacional, longitudinal, prospectivo de caráter quantitativo, realizado no período de julho de 2019 a março de 2020, em unidade de terapia intensiva neonatal (UTIN) de um hospital público universitário. Foram observados RNPT em uso de oxigenoterapia, desde o período de admissão até a alta, sendo coletados dados gestacionais, de nascimento e parâmetros da oxigenoterapia. RESULTADOS: 62 RNPT foram acompanhados com média de idade gestacional (IG) de 30,5 semanas (±3,43) e mediana de peso ao nascimento (PN) de 1.390 gramas (555 g - 3.115 g). O tempo médio de internação de 35 dias (3-176) e de oxigenoterapia foi de 7,5 dias (1-176). Ao relacionar o total de dias em oxigenoterapia com o valor do Apgar no 5º minuto, não houve relação significativa (rho= -0,158; p=0,219), porém, houve relação com a IG ao nascimento (rho= -0,725; p<0,001), uso de corticoide antenal (p=0,006) e surfactante exógeno (<0,001). Houve relação também com displasia broncopulmonar (DBP) e retinopatia da prematuridade (ROP) (p<0,001). CONCLUSÃO: Os fatores associados ao tempo e uso de oxigenoterapia foram a IG, PN, uso de corticoide antenal e surfactante exógeno, sendo observado também associação com DBP e ROP.

INTRODUCTION: Supplemental oxygen therapy reduces hypoxia by reducing mortality among preterm newborns (PTNBs), but excessive exposure to oxygen has the potential to affect and damage multiple organs of the newborn. OBJECTIVE: To determine the factors associated with the use of ventilatory support/oxygen therapy in PTNBs. MATERIALS AND METHODS: This is an observational, longitudinal, prospective quantitative study, conducted from July 2019 to March 2020, in a neonatal intensive care unit (NICU) of a public university hospital. PTNBs on oxygen therapy were observed from the time of admission to discharge, and gestational data, birth data and oxygen therapy parameters were collected. RESULTS: 62 PTNs were followed with a mean gestational age (GA) of 30.5 weeks (±3.43) and median birth weight (BW) of 1,390 grams (555 g - 3,115 g). The mean hospital stay of 35 days (3-176) and oxygen therapy was 7.5 days (1-176). When relating the total days in oxygen therapy with the value of Apgar at the 5th minute, there was no significant relationship (rho= -0.158; p=0.219), however, there was a relationship with GA at birth (rho= -0.725; p<0.001), use of antenal corticosteroids (p=0.006) and exogenous surfactante (<0.001). There was also a relationship with bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) (p<0.001). CONCLUSION: The factors associated with time and use of oxygen therapy were GA, BW, use of antenal corticosteroids and exogenous surfactant, and association with BPD and ROP was also observed.