Key result
High-flow nasal cannula oxygen therapy significantly improved stroke volume index (p=0.021) compared to conventional oxygen therapy in post-upper abdominal surgery patients.
Why the study?
The effect of high-flow nasal cannula on patient hemodynamic parameters was unknown.
Does high flow nasal cannula oxygen therapy improve early hemodynamic indicators compared to conventional oxygen therapy in post-upper abdominal surgery patients?
RCT (n=30)
Open-label
Randomized
No
Does high flow nasal cannula oxygen therapy improve early hemodynamic indicators compared to conventional oxygen therapy in post-upper abdominal surgery patients?
Absolute Event Rate: 42.95% vs 38.35%
p-value: p=0.021
In post-upper abdominal surgery patients, high flow nasal cannula oxygen therapy significantly increased stroke volume index compared to conventional oxygen therapy, though other early hemodynamic and laboratory parameters did not differ significantly.
HFNC may improve early postoperative stroke volume index; larger RCTs needed to confirm hemodynamic effects.
Background The effect of high-flow nasal cannula (HFNC) on hemodynamic data of the patients is still unknown. This was a pilot study to evaluate the effect of HFNC and conventional oxygen therapy (COT) on post-upper abdominal surgery. Methods This was an open-label randomized controlled trial (RCT) at tertiary hospital between February-June 2019. Inclusion criteria were ASA III, aged 18-65 years, BMI 18,5-29 kg/m2. Exclusion criteria were patients with unstable hemodynamic with vasopressors, general oedema, and uncooperative. Thirty patients were recruited and divided into HFNC group (n=15) and COT group (n=15). Hemodynamic parameters were recorded using the bedside monitor (heart rate, respiratory rate, and mean arterial pressure) as well as the electrical cardiometry using ICON® measurements (stroke volume index, cardiac index and systemic vascular resistance index); laboratory parameters were ScVO2 and lactate serum. Data were collected at 0, 30 and 60 minutes post-extubation. Results The General Linear Model (GLM) tests on clinical parameters (HR, RR and MAP) were P= 0.20; P=0.72; P = 0.18, ICON® parameters (SVI, CI and SVRI) were P= 0.02;P =0.64; P =0.64 meanwhile ScVO2 and lactate were P = 0.35 and P = 0.22. Despite those results, at some period of measurements there were a tendency of a better outcomes of most parameters for the HFNC group. Conclusion According to the results, the only statistically significant outcome was SVI (P =0.02) after the analysis between those two groups. However, the HFNC group showed a clinically improvement of the other outcomes among post-upper abdominal surgery patients. Keywords High flow nasal cannula, conventional oxygen therapy, haemodynamic, abdominal surgery
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Sumaratih et al. (2019) conducted an RCT in Post-upper abdominal surgery (n=30). High flow nasal cannula (HFNC) vs. Conventional oxygen therapy (COT) 3-4 L/min and 21% FiO2 was evaluated on Stroke volume index (SVI) at 60 minutes post-extubation (p=0.021). High-flow nasal cannula oxygen therapy significantly improved stroke volume index (p=0.021) compared to conventional oxygen therapy in post-upper abdominal surgery patients.
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