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J Korean Soc Emerg Med > Volume 27(6); 2016 > Article
Journal of The Korean Society of Emergency Medicine 2016;27(6): 580-585.
저산소성 호흡부전 환자의 고유속 비강 캐뉼라 산소치료 실패에 영향을 미치는 응급실 내 예측 요인
김현준1, 이동욱1, 이정원1, 문형준1, 최재형1, 정동길1, 송준환2
1순천향대학교 천안병원 응급의학과
2순천향대학교 천안병원 소아청소년과
Factors about Failure after High Flow Oxygen through Nasal Cannula Therapy in Hypoxic Respiratory Failure Patients at Emergency Department Presentation
Hyun Joon Kim1, Dong Wook Lee1, Jung Won Lee1, Hyung Jun Moon1, Jae Hyung Choi1, Dong Kil Joeng1, Jun Hwan Song2
1Department of Emergency Medicine, Soon Chun Hyang University College of Medicine, Cheonan, Korea
2Department of Pediatrics, Soon Chun Hyang University College of Medicine, Cheonan, Korea
Correspondence  Dong Wook Lee ,Tel: 041-570-2119, Fax: 041-592-3806, Email: yisfm83@gmail.com,
Received: June 29, 2016; Revised: June 30, 2016   Accepted: September 26, 2016.  Published online: December 31, 2016.
ABSTRACT
Purpose:
High-flow oxygen through a nasal cannula may offer an alternative therapy to patients with respiratory failure. However, a recent study has shown that the success rate of high-flow oxygen through a nasal cannula was only 62%, and the mortality rate for patients who require intubation after failure of high-flow oxygen through a nasal cannula was as high as 32.5%. The aim of this study is to determine the parameters, specifically for emergency department presentation, associated with high-flow oxygen through a nasal cannula failure
Method:
A retrospective cohort study was performed in respiratory patients who were admitted between June 2015 and January 2016 at a single university hospital. All patients who were treated with high-flow oxygen through a nasal cannula were included. The exclusion criteria for high-flow oxygen via nasal cannulation were as follows: Hemodynamic instability, hypercapnic coma, inefficient clearance of secretions, and cardiac arrest. Univariable regression analysis was used and, if the p-value was less than 0.10, analyses were entered into a multivariable logistic regression analysis model.
Results:
Sixty-two patients were enrolled in our study. High-flow oxygen through a nasal cannula was successful in 33 patients, and 29 required intubation. Older age (over 65 years), Glasgow Coma Scale Score of less than 15, and respiratory rate of more than 30/min were significantly associated with the failure of high-flow oxygen through a nasal cannula according to multivariable analysis (p-value<0.05).
Conclusion:
Older age, low Glasgow Coma Scale Score, and respiratory rate of more than 30/min are factors associated with the failure of high-flow oxygen through a nasal cannula.
Key words: Glasgow Coma Scale, Intubation, Respiratory insufficiency
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