Application of nasal high flow oxygen in alveolar lavage in patients with pulmonary
infection and type I respiratory failure
SHAO Jie GU Xiaolei FENG Yufeng ZHANG Jianfeng
Department of Intensive Care Medicine, the Second People's Hospital of Changshu
Objective: To investigate the effectiveness and safety of applying transnasal high-flow oxygen therapy to patients with typeⅠ respiratory failure due to pneumonia and an oxygenation index of 150-300 mmHg undergoing fibrilloscopic alveolar lavage. Methods: Seventy patients with pulmonary infection with typeⅠ respiratory failure admitted to the Department of Critical Care Medicine of the Second People's Hospital of Changshu from April 2018 to December 2020 were selected and randomly divided into two groups, and patients in the control group(33 cases) were administered oxygen by traditional mask without mechanical ventilation oxygen therapy. The treatment group(37 cases) was selected for oxygenation by transnasal high-flow oxygen therapy. Fiberoptic bronchoscopic alveolar lavage was performed on the patients under continuous cardiac monitoring. Pre-, intra-and postoperative finger pulse oxygen, pre-and postoperative oxygen partial pressure and intraoperative adverse effects due to hypoxia were monitored and recorded. Results: In the between-group comparison, there was no statistical difference between the treatment group and the control group in the comparison of preoperative and postoperative finger pulse oxygen, partial pressure of oxygen, partial pressure of carbon dioxide and oxygenation index in blood gas analysis(P>0.05), while there was a statistical difference in the change of intraoperative finger pulse oxygen(P<0.05). In intra-group comparison, there were significant differences in preoperative and postoperative finger pulse oxygen in the treatment and control groups compared to intraoperative finger pulse oxygen(P<0.05), postoperative carbon dioxide partial pressure was higher than preoperative in the control group(P<0.05), and postoperative oxygenation index was significantly improved in both the treatment and control groups(P<0.05). The control group had more adverse effects due to hypoxia relative to the treatment group, and there was a statistically significant difference between the two groups(12.12%,0,P<0.05). Conclusion: In patients with pulmonary infections in typeⅠ respiratory failure and an oxygen and oxygen index of 150-300 mmHg, alveolar lavage treatment with transnasal high-flow oxygen therapy is safer than conventional oxygen administration and is worthy of clinical promotion.
pulmonary infection; type Ⅰ respiratory failure; transnasal high flow oxygen therapy; bronchoscopic alveolar lavage;
 张健，蔡江红，彭吾训.盐酸氨溴索联合纤维支气管镜吸痰对老年重症肺炎血气指标及安全性影响的 Meta 分析[J].中华医院感染学杂志，2019,29(23):3563-3568.
 Ma ZY,Deng H,Hua LD,et al.Suspension microarray-based comparison of oropharyngeal swab and bronchoalveolar lavage fluid for pathogen identification in young children hospitalized with respiratory tract infection[J].BMC Infect Dis,2020,20(1):168.
 Li J,Zhao MH,Maierbati H,et al.Dose Response to Transnasal Pulmonary Administration of Bronchodilator Aerosols via Nasal High-Flow Therapy in Adults with Stable Chronic Obstructive Pulmonary Disease and Asthma[J].Respiration,2019,98(5):401-409.