Investigation of the efficacy of high-flow oxygen therapy in patients presenting to the emergency department with respiratory distress

ABSTRACT Investigation of the Efficacy of High-Flow Oxygen Therapy in Patients Presenting to the Emergency Department with Respiratory Distress Objective: The aim of this study was to evaluate the efficacy of high flow nasal cannula oxygen (HFNC) in patients admitted to the emergency department with respiratory distress by taking into account the changes in vital signs and blood gases values before, during and after the treatment. Materials and Methods: The study was carried out on 65 patients who were admitted to the Department of Emergency Medicine of Çukurova University Medical Faculty Department of Emergency Medicine between July 01, 2017 and February 01, 2019 with standard oxygen therapy, and did not increase oxygen saturation to ≥ 93 and were treated with HFNC over the age of 18 years. Our patients' admission to the emergency department, vital signs and Blood gases parameters, biochemical parameters (BUN, Creatinine, AST, ALT) of the 1st hour and 4th hour of HFNC treatment, diagnosis in the emergency department, oxygen saturation values at the treatment steps, requirements of mechanical ventilator support and outcome of the patients cases were recorded in the patient data record form. Findings: 65 patients were included in the study. Of the patients, 36 (55.4%) were male and 29 (44.6%) were female. 25 patients had COPD and 20 had Interstitial Lung Disease. HFNC treatment was applied to all patients. Twenty-five patients with HFNC were diagnosed with pneumonia, 20 patients with COPD attacks, and 11 patients with decompensated heart failure. A statistically significant difference was observed between the blood gases parameters (pH, PCO2, PO2, CHCO3) obtained from the 65 patients in the study at the 4th hour (p <0,05). According to this result, Blood gases parameters of Interstitial Lung Disease group were found to reach normal levels compared to other patient groups. It was determined that patients with COPD had more acidosis than Interstitial Lung Disease and other patient groups at PCO2 1st hour and 4th hour. (P <0.05) In the comparison of PO2 values of 65 patients who were treated with HFNC to the emergency department and at the 4th hour, 35 patients (53.8%) with severe hypoxemia to arrival blood gases regressed to 12 patients (18.4%) at the 4th hour. Conclusion: It was seen that HFNC treatment increased PO2 values and decreased the need for Mechanical Ventilator support in patients with acute respiratory distress in the emergency department. It was observed that blood gases parameters such as Ph, PCO2, PO2 and CHCO3 improved significantly in patients with Interstitial Lung Disease compared to other patient groups. Keywords: High flow oxygen therapy, Emergency department, Respiratory distress