High-Flow Nasal Cannula Oxygen Therapy in the Emergency Department for Patients with Acute Left Heart Failure

LU Ridong; ZHANG Jiliang; XIONG Liming

doi:10.13919/j.issn.2095-6274.ZHJY202506042

Abstract：Objective To compare the clinical efficacy of high-flow nasal cannula(HFNC)oxygen therapy versus noninvasive ventilation(NIV)in Emergency Department patients with acute left heart failure.Methods In this retrospective cohort study,90 patients with acute left heart failure admitted to Guilin People's Hospital from January 2023 to January 2025 were included and assigned to an HFNC group(observation group,45 case)or an NIV group(control group,45 case).All patients received standard heart failure therapy.Arterial blood gas indices(PaO2,PaCO2,SaO2),heart rate,respiratory rate,and cardiac function biomarkers(NT-proBNP,CK-MB)were assessed be-fore treatment and 2 hours after initiation of therapy.The rates of endotracheal intubation,28-day mortality,and Emer-gency Department length of stay were also compared.Results At 2 hours after treatment,all measured indices were significantly improved from baseline in both groups(P＜0.05).Compared with the NIV group,the HFNC group exhibited greater improvements in gas exchange(higher PaO2 and SaO2;lower PaCO2,heart rate,and respiratory rate)and cardiac function biomarkers(lower NT-proBNP and CK-MB)(P＜0.05).In addition,the HFNC group had sig-nificantly lower rates of endotracheal intubation(2.22％vs.17.78％)and 28-day mortality(2.22％vs.15.56％),and a shorter Emergency Department length of stay(P＜0.05).Conclusion For Emergency Department patients with acute left heart failure,HFNC may be noninferior and potentially superior to NIV in improving oxygenation and facili-tating recovery of cardiac function.HFNC was associated with significantly reduced intubation and mortality rates and a shorter length of stay,indicating it is a more promising option for respiratory support.