An analysis of the treatment effect of two modes of oxygenation on patients with radiation pneumonia complicated by respiratory failure

Article type: Research Article

Authors: Xing, Dong^a | Chen, Li^b | Wang, Lantao^a | Jin, Jing^c | Liu, Dong^d | Liu, Huan^a | Dong, Shimin^{e; *}

Affiliations: [a] Department of Emergency, The Fourth Hospital of Hebei Medical University, Hebei Medical University, Shijiazhuang, Hebei, China | [b] Department of General practice, The Fourth Hospital of Hebei Medical University, Hebei Medical University, Shijiazhuang, Hebei, China | [c] Department of Tumor Research Institute, The Fourth Hospital of Hebei Medical University, Hebei Medical University, Shijiazhuang, Hebei, China | [d] Department of Anesthesiology, Baoding No. 1 Hospital, Baoding, Hebei, China | [e] Department of Emergency, The Third Hospital of Hebei Medical University, Hebei Medical University, Shijiazhuang, Hebei, China

Correspondence: [*] Corresponding author: Shimin Dong, Department of Emergency, The Third Hospital of Hebei Medical University, Hebei Medical University, No. 139 of Ziqiang Road, Qiaoxi District, Shijiazhuang, Hebei 050051, China. Tel.: +86 185 3311 2992; E-mail: dsmimmm@21cn.com.

Abstract: BACKGROUND: Stereotactic radiotherapy (SBRT) is widely used in the treatment of thoracic cancer. OBJECTIVE: To evaluate the efficacy of a non-rebreather mask (NRBM) and high-flow nasal cannula (HFNC) in patients with radiation pneumonia complicated with respiratory failure. METHODS: This was a single-center randomized controlled study. Patients admitted to the EICU of the Fourth Hospital of Hebei Medical University were selected and divided into NRBM and HFNC group. Arterial blood gas analysis, tidal volume, respiratory rates and the cases of patients receiving invasive assisted ventilation were collected at 0, 4, 8, 12, 24, 48, and 72 h after admission. RESULTS: (1) The PaO2/FiO2, respiratory rates, and tidal volume between the two groups at 0, 4, 8, 12, 24, 48, and 72 h were different, with F values of 258.177, 294.121, and 134.372, all P< 0.01. These indicators were different under two modes of oxygenation, with F values of 40.671, 168.742, and 55.353, all P< 0.01, also varied with time, with an F value of 7.480, 9.115, and 12.165, all P< 0.01. (2) The incidence of trachea intubation within 72 h between HFNC and NRBM groups (23 [37.1%] vs. 34 [54.0%], P< 0.05). The transition time to mechanical ventilation in the HFNC and NRBM groups (55.3 ± 3.2 h vs. 45.9 ± 3.6 h, P< 0.05). (3) The risk of intubation in patients with an APACHE-II score > 23 was 2.557 times than score ⩽ 23, and the risk of intubation in the NRBM group was 1.948 times more than the HFNC group (P< 0.05). CONCLUSION: Compared with the NRBM, HFNC can improve the oxygenation state of patients with radiation pneumonia complicated with respiratory failure in a short time, and reduce the incidence of trachea intubation within 72 h.

Keywords: Non-rebreather mask, high-flow oxygen nasal cannula, radiation pneumonia, respiratory failure, treatment effect

DOI: 10.3233/THC-213597

Journal: Technology and Health Care, vol. 30, no. 4, pp. 869-880, 2022