PDF(Pubmed)
Abstract：
(1) Background: Although Non-Invasive Ventilation (NIV) is effective in preventing mortality and endotracheal intubation in patients with Acute Respiratory Failure (ARF) linked to a neuromuscular disorder, its efficacy can be affected by patient intolerance. A High-Flow Nasal Cannula (HFNC) appears to have a significant advantage over NIV as far as patient tolerance is concerned. The aim of the study was to investigate HFNC\'s safety profile in a group of consecutive Neuromuscular Disease (NMD) patients intolerant to NIV who were admitted to an Intermediate Respiratory Care Unit (IRCU) for ARF. (2) Methods: The clinical course of nine NMD patients intolerant to NIV and switched to HFNC was reported. HFNC was provided during daytime hours and NIV during the night-time to the NIV-intolerant patients. HFNC was utilized 24 h a day in those patients who were intolerant of even nocturnal NIV. (3) Results: HFNC was simple to use and it was well tolerated by all of the patients. Three out of nine patients experienced treatment failure, consisting of the need for ETI and/or death during their IRCU stay. The remaining 6 had a favorable outcome. Treatment failure was linked to the utilization of HFNC 24 h a day. (4) Conclusion: HFNC during the daytime hours, together with nocturnal NIV, seems to be a safe therapeutic approach for NMD patients with ARF. A round-the-clock use of HFNC tends to be linked to a high likelihood of failure.
摘要：
（1）背景：尽管非侵入性通气（NIV）可有效预防与神经肌肉疾病相关的急性呼吸衰竭（ARF）患者的死亡率和气管插管，其疗效可能受到患者不耐受的影响。就患者耐受性而言，高流量鼻套管（HFNC）似乎比NIV具有显着的优势。该研究的目的是调查一组连续的神经肌肉疾病（NMD）患者中HFNC的安全性，这些患者对NIV不耐受，这些患者因ARF进入中级呼吸监护病房（IRCU）。（2）方法：报告9例NMD患者对NIV不耐受并改用HFNC的临床过程。对不耐受NIV的患者在白天提供HFNC，在夜间提供NIV。对于那些甚至不耐受夜间NIV的患者，每天24小时使用HFNC。（3）结果：HFNC使用简单，所有患者均耐受良好。九分之三的病人经历了治疗失败,包括在IRCU逗留期间需要ETI和/或死亡。其余6人取得了良好的结果。治疗失败与每天24小时使用HFNC有关。（4）结论：HFNC在白天时段，连同夜间NIV,似乎是一种安全的治疗方法NMD患者ARF。全天候使用HFNC往往与故障的高可能性有关。
