A comparative study between high-flow nasal oxygen therapy and venturi mask oxygen therapy for postoperative laparoscopic bariatric surgery patients with atelectasis: a randomized clinical trial

Abstract

Abstract Background Obesity has been identified as an independent risk factor for postoperative respiratory complications in several studies. In the pediatric and newborn populations, high-flow nasal oxygen (HFNO2) therapy was initially demonstrated to be an effective treatment for acute respiratory failure. It becomes increasingly popular as a therapy for adult patients, with a growing range of clinical applications. Results One hundred ten patients were admitted to the ICU for postoperative care after laparoscopic sleeve gastrectomy. They were examined and randomized equally into two groups: group A (HFNO2 therapy group) who received high-flow nasal oxygen therapy, group B (VMO2 therapy group) who received venturi mask oxygen therapy. The partial pressure of oxygen in arterial blood (PaO2), partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2), respiratory rate, and length of ICU stay were recorded. The partial pressure of oxygen in the arterial blood (PaO2) was 131.764 (95% CI 124.562–138.965) in the HFNO2 group versus 106.767 (95% CI 99.565–113.968) in the VMO2 group, partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2) was 321.81 (95% CI 307.486–336.153) in the HFNO2 group versus 276.767 (95% CI 262.433–291.100) in the VMO2 group, and respiratory rate was 20.778 (95% CI 20.172–21.385) in the HFNO2 group versus 24.047 (95% CI 23.441–24.654) in the VMO2 group, while the length of ICU stay was the HFNO2 group (1.09 ± .29 days) and (1.00 ± .000 day) in the VMO2 group. Conclusions In conclusion, our study has shown that high-flow nasal oxygen therapy in postoperative laparoscopic sleeve gastrectomy patients with atelectasis-maintained oxygenation represented as PaO2 and PaO2/FiO2 higher than the venturi mask and significantly decreased the respiratory rate but did not decrease the length of ICU stay when compared to venturi mask oxygen therapy. Trial registration Clinical trial registered with http://www.pactr.org (PACTR202108492295773).