High-Flow Nasal Cannula Versus Conventional Oxygen Therapy in Emergency Department Patients With Cardiogenic Pulmonary Edema: A Randomized Controlled Trial - 23/09/17
Abstract |
Study objective |
High-flow nasal cannula is a new method for delivering high-flow supplemental oxygen for victims of respiratory failure. This randomized controlled trial compares high-flow nasal cannula with conventional oxygen therapy in emergency department (ED) patients with cardiogenic pulmonary edema.
Methods |
We conducted an open-label randomized controlled trial in the ED of Siriraj Hospital, Bangkok, Thailand. Patients aged 18 years or older with cardiogenic pulmonary edema were randomly assigned to receive either conventional oxygen therapy or high-flow nasal cannula. The primary outcome was the respiratory rate 60 minutes postintervention.
Results |
We enrolled 128 participants (65 in the conventional oxygen therapy and 63 in the high-flow nasal cannula groups). Baseline high-flow nasal cannula and conventional oxygen therapy mean respiratory rates were 28.7 breaths/min (SD 3.2) and 28.6 breaths/min (SD 3.5). Mean respiratory rates at 60 minutes postintervention were lower in the high-flow nasal cannula group (21.8 versus 25.1 breaths/min; difference 3.3; 95% confidence interval 1.9 to 4.6). No significant differences were found in the admission rate, ED and hospital lengths of stay, noninvasive ventilation, intubation, or mortality.
Conclusion |
In patients with cardiogenic pulmonary edema in the ED, high-flow nasal cannula therapy may decrease the severity of dyspnea during the first hour of treatment.
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| Please see page 466 for the Editor’s Capsule Summary of this article. |
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| Supervising editor: Henry E. Wang, MD, MS |
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| Author contributions: OM and TN conceived the study, designed the trial, and supervised the conduct of the trial and data collection. OM, AM, US, NP, WC, TC, CP, and TN recruited the patients and managed the data, including quality control. PT interpreted the radiologic outcomes. OM analyzed the data. OM drafted the article, and all authors contributed substantially to its revision. OM takes responsibility for the paper as a whole. |
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| All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). Fisher & Paykel Healthcare Limited (Auckland, New Zealand) provided the equipment required for high-flow nasal cannula. |
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| Trial registration number: TCTR20150727001 |
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| Fisher & Paykel Healthcare Limited had no involvement in the study conduct or data analysis or interpretation. |
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Vol 70 - N° 4
P. 465 - octobre 2017 Retour au numéro
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