Sequential efficacy of non-invasive positive pressure ventilation combined with high-flow nasal cannula oxygen therapy in high-risk patients after mechanical ventilation extubation
HE Yong
Abstract：Objective:To explore the sequential application value of non-invasive positive pressure ventilation(NPPV)combined with high-flow nasal cannula oxygen therapy(HFNC)in high-risk patients after mechanical ventilation extubation.Methods:Eighty patients with high-risk acute respiratory failure after weaning and extubation admitted to the ICU of Rongxian People's Hospital from July 2023 to February 2025 were selected and randomly divided into experimental group and conventional group,with 40 patients in each group.The experimental group was treated with NPPV combined with HFNC,while the conventional group was treated with NPPV.The vital signs,blood gas indicators,sputum viscosity,and comfort scores of the two groups of patients at different time points(2 h,6 h,12 h,24 h,and 48 h)after extubation were compared,and the re-intubation rate,mortality rate,and incidence of complications within 28 d were evaluated.Results:①The heart rate and respiration of patients in the conventional group were higher than those in the experimental group at 2 h,6 h,12 h,24 h,and 48 h after extubation.The SpO₂ of patients in the conventional group was lower than that in the experimental group at 2 h,6 h,12 h,24 h,and 48 h after extubation(P<0.05).②There was no significant difference in pH levels between the two groups of patients at 2 h,6 h,12 h,24 h,and 48 h after extubation(P>0.05).The PCO2 and HCO2 of patients in the experimental group were significantly lower than those in the conventional group at 2 h,6 h,12 h,24 h,and 48 h after extubation(P<0.05).The PO2 and oxygenation index of patients in the experimental group were significantly higher than those in the conventional group at 2 h,6 h,12 h,24 h,and 48 h after extubation(P<0.05).③There were significant differences in the number of patients with grades Ⅰ,Ⅱ,and Ⅲ between the experimental group and the conventional group at 2 h,6 h,12 h,24 h,and 48 h after extubation(P<0.05).④The comfort scores of patients in the experimental group at 2 h,6 h,12 h,24 h,and 48 h after extubation were higher than those in the conventional group(P<0.05).⑤The re-intubation rate of patients in the experimental group within 48 h was lower than that in the conventional group(P<0.05).The mortality rate at 2 d was lower than that in the conventional group(P<0.05),and the mortality rate at 7 d was lower than that in the conventional group.⑥ The incidence of complications in the experimental group was lower than that in the conventional group(P<0.05).Conclusion:The sequential application of NPPV combined with HFNC in high-risk patients after mechanical ventilation extubation has significant effects.It can effectively improve patients'vital signs,blood gas indicators,reduce the re-intubation rate and mortality rate within 28 d,improve patient comfort,and reduce the incidence of complications.It is worth promoting.
Keywords：non-invasive positive pressure ventilationhigh-flow nasal cannula oxygen therapyhigh-risk patients after mechanical ventilation extubationcurative effect
Publication Date：2025-06-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 47-52 )