经鼻高流量氧疗治疗急性呼吸衰竭的参数设置

Parameters setting of high-flow nasal cannula oxygen therapy for acute respiratory failure

经鼻高流量氧疗广泛应用于急性呼吸衰竭治疗,可以改善患者氧合状况、呼吸功和肺脏气体分布。通过调整氧浓度、湿化罐温度和气体流量三个参数,经鼻高流量氧疗提供高浓度氧气、湿化吸入气体和高流量气体。气体温度过低会影响呼吸道黏液纤毛功能,温度过高则影响患者舒适性。气体流量过低不但降低吸入氧气浓度,改善呼吸功作用也有限。为保证最佳治疗效果和患者的舒适性,氧浓度设置以目标氧饱和度为依据,湿化罐温度一般设置为34~35℃,气体流量一般设置为60 L/min或患者最大耐受流量。经鼻高流量氧疗各参数设置需要根据患者病情、个人耐受程度采取个体化方案。

High-flow nasal cannula(HFNC)is widely used in the treatment of acute respiratory failure,and can improve the patients′oxygenation,work of breath and air distribution in the lungs.HFNC provides the patients with high concentration of oxygen,humidified inhaled oxygen and high-flow rate of oxygen by adjusting the three parameters of oxygen concentration,humidifier temperature and inspired gas flow.Too low gas temperature deteriorates the airway mucociliary function while too high gas temperature discomforts the patients.The low gas flow not only reduces the inspired oxygen concentration,but also makes the improvement of work of breath limited.In order to ensure the best therapeutic effect and meet the comfort of the patients,the oxygen concentration is adjusted according to the targeted oxygen saturation,and the humidifier temperature is generally set at 34-35℃,and the gas flow rate is generally set at 60 L/min or the maximum tolerated flow rate of the patients.The parameters setting of HFNC needs to be individualized according to the patient′s condition and individual tolerance.