Efficacy Of High Flow Nasal Cannula In Acute Hypercapnic Respiratory Failure Patients

Abstract

Introduction: Acute hypercapnic respiratory failure (AHRF) is a respiratory disorder caused by inadequate alveolar ventilation, resulting in hypercapnia. The high-flow nasal cannula (HFNC) is being utilized and tested as an novel alternate technique for managing AHRF. The aim of the present study to assess the efficacy of HFNC therapy in acute type 2 respiratory failure and possible predictors of response to HFNC therapy. Patients and methods: This prospective cohort study was conducted at intensive care unit (ICU) of chest department, Zagazig university (from February to August 2023) on 40 cases with mild –moderate acute hypercapnic respiratory failure (PH 7.25-7.35, PaCO2 above 50mmHg and PaO2 <60 mmHg). HFNC therapy was started after failure of conventional oxygen therapy (at least 4 hours in the next 24 hours). Arterial blood gas (ABG) findings, vital signs, and patient comfort were closely monitored before HFNC, at 2 hours and 4 hours. Results: 40 Cases were enrolled in this study with mean age 61.9± 12 and mean total APACHE 2 score 12.3±3.2. 75% of cases improved regarding ABG findings, vital signs and respiratory rate Oxygenation (ROX) index while 25% needed mechanical ventilation. There was a statistically significant difference and improvement regarding, PaCO2, PaO2, ROX index, PaO2, consciousness and patient comfort scale after HFNC (p<0.05).Conclusion: use of HFNC is effective in lowering PaCO2, heart rate and respiratory rate and in relief of overuse of accessory muscles also improves oxygenation and patient comfort in cases of mild-moderate acute on top of chronic type 2 respiratory failure (RF).