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Benefits of High-Flow Nasal Cannula Therapy for Acute Pulmonary Edema in Patients with Heart Failure in the Emergency Department: A Prospective Multi-Center Randomized Controlled Trial

Authors
 Dong Ryul Ko  ;  Jinho Beom  ;  Hye Sun Lee  ;  Je Sung You  ;  Hyun Soo Chun  ;  Sung Phil Chung 
Citation
 JOURNAL OF CLINICAL MEDICINE, Vol.9(6) : 1937, 2020-06 
Journal Title
 JOURNAL OF CLINICAL MEDICINE 
Issue Date
2020-06
Keywords
acute pulmonary edema ; arterial blood gas ; heart failure ; high-flow nasal cannula ; lactate
Abstract
Heart failure patients with pulmonary edema presenting to the emergency department (ED) require an effective approach to deliver sufficient oxygen and reduce the rate of intubation and mechanical ventilation in the ED; conventional oxygen therapy has proven ineffective in delivering enough oxygen to the tissues. We aimed to identify whether high-flow nasal cannula (HFNC) therapy over time improved the respiratory rate (RR), lactate clearance, and certain arterial blood gas (ABG) parameters, in comparison with conventional oxygen therapy, in patients with cardiogenic pulmonary edema. This prospective, multi-institutional, and interventional study (clinical trial, reference KCT0004578) conducted between 2016 and 2019 included adult patients diagnosed with heart failure within the previous year and pulmonary edema confirmed at admission. Patients were randomly assigned to the conventional or HFNC group and treated with the goal of maintaining oxygen saturation (SpO2) ≥ 93. We obtained RR, SpO2, lactate levels, and ABG parameters at baseline and 30 and 60 min after randomization. All parameters showed greater improvement with HFNC therapy than with conventional therapy. Significant changes in ABG parameters were achieved within 30 min. HFNC therapy could therefore be considered as initial oxygen therapy. Physicians may consider advanced ventilation if there is no significant improvement in ABG parameters within 30 min of HFNC therapy.
Files in This Item:
T202002143.pdf Download
DOI
10.3390/jcm9061937
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Ko, Dong Ryul(고동률) ORCID logo https://orcid.org/0000-0002-3098-2784
Beom, Jin Ho(범진호) ORCID logo https://orcid.org/0000-0002-2805-257X
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Chung, Sung Phil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Chung, Hyun Soo(정현수) ORCID logo https://orcid.org/0000-0001-6110-1495
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/179369
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