Comparison of Mask Oxygen Therapy and High-Flow Oxygen Therapy after Cardiopulmonary Bypass in Obese Patients

Abstract

Background To clarify the efficiency of mask O2 and high-flow O2 (HFO) treatments following cardiopulmonary bypass (CPB) in obese patients. Methods During follow-up, oxygenization parameters including arterial pressure of oxygen (PaO2), peripheral oxygen saturation (SpO2), and arterial partial pressure of carbon dioxide (PaCO2) and physical examination parameters including respiratory rate, heart rate, and arterial pressure were recorded respectively. Presence of atelectasia and dyspnea was noted. Also, comfort scores of patients were evaluated. Results Mean duration of hospital stay was 6.9 ± 1.1 days in the mask O2 group, whereas the duration was significantly shorter (6.5 ± 0.7 days) in the HFO group (p=0.034). The PaO2 values and SpO2 values were significantly higher, and PaCO2 values were significantly lower in patients who received HFO after 4th, 12th, 24th, 36th, and 48th hours. In postoperative course, HFO leads patients to achieve better postoperative FVC (p < 0.001). Also, dyspnea scores and comfort scores were significantly better in patients who received HFO in both postoperative day 1 and day 2 (p < 0.001, p < 0.001 and p=0.002, p=0.001, resp.). Conclusion Our study demonstrated that HFO following CPB in obese patients improved postoperative PaO2, SpO2, and PaCO2 values and decreased the atelectasis score, reintubation, and mortality rates when compared with mask O2.

Comparison of High-flow Nasal Cannula (HFNC) and Conventional Oxygen Therapy in Obese Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis

“…We summarized the study and patient characteristics included in the studies in Table I and Table II. Among the included studies, two studies (16,18) were RCTs. The study of Stéphan et al (19) is a post hoc analysis of a predesigned RCT (20).…”

“…Two studies reported the reintubation and the sample size was 255. In the report by Sahin et al (18), the number of reintubation was 0 for the HFNC group and 4 for the COT group. The nosocomial pneumonia reported by Corley et al (16) was 0 for the HFNC group and 1 for the COT group.…”

The role for high flow nasal cannula as a respiratory support strategy in adults: a clinical practice guideline

“…Ten trials [51][52][53][54][55][56][57][58][59][60] compared prophylactic HFNC to COT and only one trial compared HFNC to NIPPV [61]. Of these, six trials were conducted in patients following cardiac surgery [53,55,57,58], four trials were conducted following thoracic surgery [51,52,56], and one trial was performed in patients after major combined thoracic and abdominal surgery [54]. With the exception of blinding, all trials, except one [52], were judged to be at low or probably low risk of bias.…”

High-Flow Nasal Cannula vs Conventional Oxygen Therapy for Postcardiothoracic Surgery

“…38 However, none of the studies comparing HFNC with conventional oxygen therapy during and after cardiothoracic surgery reported differences in FEV 1 before and after surgery between groups. 20,21,39 More studies are needed to confirm the relationship between air-flow limitation and length of hospital stay in patients undergoing cardiothoracic surgery. In addition, the criteria for discharge from the hospital were not identical among different medical centers, which might lead to an insignificant difference in the stay between the groups.…”

“…Finally, 8 articles met our inclusion criteria and were selected for data extraction, analysis, and quality assessment. [16][17][18][19][20][21][22][23] A flow chart of the search strategy and the reasons for exclusion are shown in Figure 1.…”