الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
High-flow nasal cannula (HFNC), which delivers heated and humidified oxygen and air via nasal prongs with a maximum flow of 60 L/min and at a prescribed inspired oxygen concentration, might provide an alternative to COT or NIV. High flow nasal cannula (HFNC) is a respiratory support system that has become prominent in the treatment of respiratory failure, and studies are available showing a reduction in intubation and mortality. HFNC provides higher concentration and flow of oxygen, resulting in decreasing anatomic dead space by preventing rebreathing and ensure positive end-expiratory pressure The aim of this study was to evaluate prophylactic immediately applied high-flow nasal cannula compared to conventional oxygen therapy (COT) after extubation on reducing the rate of reintubation. Identify factors that could predict the success or failure of HFNC. This prospective randomized controlled clinical study was carried out in 2 surgical intensive care units (Tanta University Hospital and Tanta Cancer Center) after approval of ethical committee In this study 146 patients were randomized into two groups 73 patients in each one : COT group (A), HFNC group (B). • group A (control group) 73 patients: Conventional oxygen therapy (COT) is defined as blended air/oxygen that is not heated on humidified at a flow rate <15L/min. Applied through nasal cannula or face mask. • group B (High-Flow nasal Cannula) 73 Patients: High-flow nasal cannula (HFNC) is defined as air/oxygen mixture at a flow ≥30L/min delivered via heated, humidified circuit and prongs. Monitoring: The vital signs: was monitored continuously at the bedside and recorded at 1,6,12,24,36 hrs. a. Body temperature b. Heart rate c. Respiratory rate d. Blood pressure e. Pulse blood oxygen saturation Laboratory tests: Arterial blood gases were measured in all patients one hour after extubation, at 4, 8, 12, 24, 36 hrs. Demographic data and Measurements: a) Age. b) Gender. c) BMI. d) Primary diagnosis. e) Comorbidity. f) Time to reintubation. g) Reasons for reintubation. h) APCHE II. i) Anew index termed ROX j) the development of postoperative hypoxemia, pneumonia, reintubation and/or use of curative NIV because of postoperative respiratory failure. k) ICU and hospital lengths of stay. The results of our study showed: 1. Concerning the patient demographic data of the studied groups: there were statically insignificant differences between the two groups as regard gender, age and body math index (Kg/m2). 2. Concerning the Lung Injury Prediction Score of the participants: There was statistically insignificant difference between the two groups as regard to LIPS. 3. There was no statistically significant difference between the two groups as regard to Primary diagnosis and Co morbidities. 4. Concerning to the time to reintubation in hours of the participants and the reasons of reintubation (Persistent hypoxia, Tachypnea, Hemodynamic instability and adding vasopressor ,retained secretion and Disturbance conscious level) and post-operative respiratory failure in our study: There was statistically significant difference between the two groups. 5. Concerning to APACHE II of the participants: There was statistically insignificant difference between the two groups as regard to APACHE II At ICU admission and There was statistically significant difference between the two groups as regard to APACHE II at discharge. 6. Concerning to the vital signs in our study: Comparing the body temperature and blood pressure between the two studied groups after 1,6,12,24 and 36 hrs showed that there was statistically insignificant difference between both groups. Comparing the heart rate between the two studied groups after 1, 6,12 and 36 hrs showed that there was statistically significant difference between both groups, while there was no statistically difference after 24. Comparing the Respiratory rate between the two studied groups after 1, 6 and 12 hrs showed that there was statistically significant difference between both groups ,while there was no statistically difference after 24 and 36 hrs. Comparing the saturation There was statistically significant difference between the two groups after 1 and 36 hr, while there was statistically insignificant difference between the two groups after 6,12 and 24 hr. Comparing the Respiratory rate between the two studied groups after 1, 6 and 12 hrs showed that there was statistically significant difference between both groups ,while there was no statistically difference after 24 and 36 hrs . Concerning to the ABG in our study: Comparing the Arterial PH between the two studied groups after 1and 4 hrs showed that there was statistically significant difference between both groups ,while there was no statistically difference after 12, 24 and 36 hrs. Comparing the PaCO₂ mmHg between the two studied groups after 4 hrs showed that there was statistically significant difference between both groups while there was no statistically difference after 1,12,24 and 36 hrs. Comparing the P/F between the two studied groups after 1, 4, 12,24 and 36 hrs showed that there was statistically significant difference between both groups . 7. Concerning to the ROX in our study: Comparing the Rox between the two studied groups after 6 and 12 hrs showed that there was statistically significant difference between both groups, while there was no statistically difference after 24 and 36 hrs. 8. Concerning to the Intensive Care unit (ICU) & Hospital length Stay (HLS) of the participants in our study: Comparing the ICU Stay and The HLS between the two studied groups showed that there was statistically significant difference. 9. Concerning to the in-hospital mortality of the participants Comparing the hospital mortality between the two studied groups showed that there was statistically insignificant difference.