Objective
This study assessed the efficacy of high-flow humidified oxygen (HFHO) as an alternative
to continuous positive airway pressure (CPAP) for improving oxygenation while preserving
nonventilated lung collapse during one-lung ventilation.
Design
A prospective randomized cross-over trial.
Setting
A tertiary medical center.
Participants
The study comprised 28 patients undergoing elective thoracotomy with one-lung ventilation
using a double-lumen endobronchial tube placement.
Interventions
The patients received prophylactic CPAP or HFHO to the nonventilated lung for 20 minutes
and were then crossedover to the other oxygenation modality for 20 minutes, with a
20-minute recovery interval between the two modalities.
Measurements and Main Results
Changes in respiratory parameters and lung deflation quality were recorded. Both CPAP
and HFHO increased the partial pressure of arterial oxygen in either sequence in both
groups, ranging from 31.8-to-66.0 mmHg. However, the increments from these two interventions
were not statistically significant (95% confidence interval –12.84 to 21.87; p = 0.597). There were no differences in other parameters. Half the patients receiving CPAP
experienced worsening of the surgical condition, whereas the HFHO patients experienced
no change or reported a better lung deflation (p < 0.001).
Conclusion
HFHO could be an alternative method to CPAP for improving arterial oxygenation while
preserving lung deflation during one-lung ventilation. However, additional studies
are warranted in regard to its cost-effectiveness and establishment as a routine treatment.
Key Words
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Article info
Publication history
Published online: April 07, 2021
Footnotes
This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors
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