Effect of high-flow nasal cannula oxygen therapy on early respiratory distress in patients with acute paraquat poisoning / 中华急诊医学杂志

ABSTRACT

Objective:To evaluate the effect of high-flow nasal cannula (HFNC) oxygen on the early respiratory distress in patients with acute paraquat poisoning.Methods:This prospective study included patients who were hospitalized in the Emergency Department of First Hospital of China Medical University diagnosed and were diagnosed with acute PQ poisoning from May 1, 2017 to May 1, 2018. Inclusion criteria acute PQ poisoning patients with dyspnea, and meet the following conditions dyspnea with RR > 25 beats/min or PCO 2 < 32 mmHg. The following information were recorded RR, SpO 2, HR and MAP before and 15 min, 30 min, 1 h, 2 h, 4 h, 6 h, 12 h and 24 h after HFNC application, as well as and arterial blood gas before and 6 h, 24 h after HFNC application. The improvement of RR, SpO 2, HR, MAP, PCO 2, PO 2, pH and Lac were compared before and after HFNC. Mann-Whitney U rank test and Chi-square test were used and a P<0.05 was regarded as statistically significant. Results:A total of 50 patients were included in the study. After 28 days of follow-up, 26 patients survived and 24 died. There was no difference between the two groups in gender and age. There were differences in PQ oral doses, urinal PQ concentration, Lac and PaCO 2 between the two groups. HFNC significantly reduced the RR and HR of all patients at all time points, and PaCO 2 was significantly increased at 6 h after application, 36 mmHg(34, 38) mmHg vs 30 mmHg (27, 32) mmHg ( P<0.05), while MAP, SpO 2, PO 2, and pH had no significant differences. RR and HR of the survival group were significantly lower than those of the non-survival group, as well as the maximum flow rate, 35 L/min (25, 40) L/min vs 55 L/min(50, 60) L/min ( P<0.01). Conclusions:HFNC can significantly reduce the early respiratory frequency and heart rate of patients with acute PQ poisoning and improve dyspnea. Meanwhile, it can significantly reduce the patients' oxygen consumption and improve the relative or absolute hypoxic state of patients after poisoning.