Therapeutic effect of high-flow nasal cannula in patients with severe heart failure

Zhang Yan; Gong Yumiao; Jiao Huan; Zhang Cui

doi:10.3969/j.issn.1674-4055.2025.06.15

Abstract：Objective To discuss the clinical efficacy and difficulty level of nursing operations of high-flow nasal cannula(HFNC)in patients with severe heart failure(HF).Methods The patients with severe HF and hyoxemia(n=86)were selected from the Seventh Medical Center of Chinese PLA General Hospital from Jan.2023 to June 2024.All patients were divided,according to random digital table,into experimental group(using HFNC)and control group(using non-invasive ventilator positive pressure ventilation,each n=43).The adequate oxygen therapy was provided while drugs for HF were optimized[tolasemide,spironolactone,recombinant human brain natriuretic peptide(rhBNP),sakubatril-valsartan,dapagliflozin and betaloc].The specific medication programs were formulated according to symptoms,signs and liver and kidney functions,and treatment were continued for 10 d.The changes of clinical efficacy,scores of Bruggrmann Comfort Scale(BCS),respiratory parameters before and after treatment[respiratory rate(RR),oxygen saturation(SpO2)],heart rate(HR)and blood gas analysis indicators,and nursing operations were compared between 2 groups.Results The total effective rate was higher in experimental group than that in control group(97.67%vs.81.40%,P＜0.05).The differences in respiratory parameters before and after treatment and HR had no statistical significance between 2 groups before treatment(P＞0.05),and RR and HR were lower,and SpO2 was higher in experimental group than those in control group after treatment(P＜0.05).The differences in blood gas analysis monitoring indicators[arterial partial pressure of oxygen(PaO2),oxygenation index(OI),pH value,lactic acid(LA)]had no statistical significance between 2 groups before treatment(P＞0.05).PaO2 and OI were higher in experimental group than those in control group(P＜0.01),and differences in pH value and LA had statistical significance between 2 groups after treatment(P＞0.05).BCS scores were significantly higher in experimental group than that in control group[(62.59±4.09)vs.(50.38±4.27),P＜0.01)].The operational skill difficulty,operator requirements,operator workload intensity and operation time were lower in experimental group than those in control group(P＜0.01).The differences in operational risk and operator willingness had no statistical significance between 2 groups(P＞0.05).Conclusion HFNC can improve clinical efficacy,respiratory function and comfort level,and reduce difficulty and time of nursing operations in patients with severe HF and hyoxemia,which can be applied in clinical rescue.