The Clinical Effect of High-Flow Oxygen Therapy through the Nose on Patients with Acute Left Heart Failure and Hypoxemia

Abstract

Objective. To evaluate the clinical efficacy of nasal high-flow oxygen therapy in patients with acute left heart failure and hypoxemia. Methods. From July 2016 to November 2018, patients with acute left heart failure complicated with hypoxemia treated in the Department of Critical Medicine of Yantai Affiliated Hospital of Binzhou Medical University were retrospectively observed (a total of 140 cases met the inclusion criteria). They were randomly divided into two groups, with 70 cases in each group. Patients were given continuous ECG monitoring, improved blood gas analysis test, and recorded HR, RR, map, SaO2, pH, PaO2, PaCO2, and Lac, perfect examination and color Doppler echocardiography, and record NT-proBNP and EF before and 24 hours after treatment. The effective rates of the two groups before and after oxygen therapy were detected. Results. There were 67 patients with high-flow oxygen therapy group improvement, 95.7% improvement rate, and 55 patients with general oxygen therapy group improvement rate. The treatment improvement rate was 78.6%. A total of 67 patients were treated with high-flow oxygen therapy. After high-flow oxygen therapy, HR (t = 18.8, $P\le 0.05$ ), RR (t = 19.7, $P\le 0.05$ ), MAP (t = 12.1, $P\le 0.05$ ), PaCO2 (t = 9.53, $P\le 0.05$ ), Lac (t = 8.69, $P\le 0.05$ ), and NT-proBNP (t = 7.03, $P\le 0.05$ ) were significantly lower than before. SaO2 (t = −12.4, $P\le 0.05$ ), pH (t = −12.2, $P\le 0.05$ ), PaO2 (t = −17.7, $P\le 0.05$ ), and EF (t = −13.4, $P\le 0.05$ ) were significantly higher than before. A total of 55 patients were in the general oxygen therapy group. After administration of ordinary oxygen therapy, HR (t = 18.2, $P\le 0.05$ ), RR (t = 10.8, $P\le 0.05$ ), MAP (t = 13.1, $P\le 0.05$ ), PaCO2 (t = 15.8, $P\le 0.05$ ), Lac (t = 7.1, $P\le 0.05$ ), and NT-proBNP (t = 10, $P\le 0.05$ ) were significantly lower than before. SaO2 (t = −15.5, $P\le 0.05$ ), pH (t = −4.5, $P\le 0.05$ ), PaO2 (t = −20, $P\le 0.05$ ), and EF value (t = −7.7, $P\le 0.05$ ) were significantly higher than before. Conclusion. High-flow oxygen therapy and general oxygen therapy have an obvious curative effect on patients with acute left heart failure and hypoxemia. Compared with the two, high-flow oxygen therapy is more effective. After high-flow oxygen therapy and general oxygen therapy in patients with acute left heart failure and hypoxia, HR, RR, MAP, SaO2, pH, PaO2, PaCO2, Lac, EF, and NT-proBNP value all improved, and the improvement of high-flow oxygen therapy was greater.