Comparison of High-Flow Humidified Oxygen With Conventional Continuous Positive Airway Pressure in Nonventilated Lungs During Thoracic Surgery: A Randomized Cross-Over Study
Prasert Sawasdiwipachai, Ratchaya Weerayutwattana, Punnarerk Thongcharoen, ศิริลักษณ์ สุขสมปอง*
Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand; Email: sirilak.suk@mahidol.ac.th.
บทคัดย่อ

Objective: This study assessed the efficacy of high-flow humidified oxygen (HFHO) as an alternative to continuous positive airway pressure (CPAP) for improving oxygenation while preserving nonventilated lung collapse during one-lung ventilation.

Design: A prospective randomized cross-over trial.

Setting: A tertiary medical center.

Participants: The study comprised 28 patients undergoing elective thoracotomy with one-lung ventilation using a double-lumen endobronchial tube placement.

Interventions: The patients received prophylactic CPAP or HFHO to the nonventilated lung for 20 minutes and were then crossedover to the other oxygenation modality for 20 minutes, with a 20-minute recovery interval between the two modalities.

Measurements and main results: Changes in respiratory parameters and lung deflation quality were recorded. Both CPAP and HFHO increased the partial pressure of arterial oxygen in either sequence in both groups, ranging from 31.8-to-66.0 mmHg. However, the increments from these two interventions were not statistically significant (95% confidence interval -12.84 to 21.87; p = 0.597). There were no differences in other parameters. Half the patients receiving CPAP experienced worsening of the surgical condition, whereas the HFHO patients experienced no change or reported a better lung deflation (p < 0.001).

Conclusion: HFHO could be an alternative method to CPAP for improving arterial oxygenation while preserving lung deflation during one-lung ventilation. However, additional studies are warranted in regard to its cost-effectiveness and establishment as a routine treatment.

 
ที่มา
Journal of Cardiothoracic and Vascular Anesthesia ปี 2564, October ปีที่: 35 ฉบับที่ 10 หน้า 2954-2951
คำสำคัญ
continuous positive airway pressure, CPAP, high-flow humidified oxygen, hypoxemia during one-lung ventilation, lung collapse, one-lung ventilation