Tailored Predictive Indicators for Weaning Success from High-Flow Nasal Cannula in Postoperative Hypoxemic Patients
The use of high-flow nasal cannula (HFNC) as an oxygen therapy post-extubation has demonstrated varying success rates across different surgical populations. This study aimed to identify the predictive factors influencing HFNC weaning outcomes in patients with postoperative extubation hypoxemia. We c...
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MDPI AG
2025-02-01
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| author | Yuh-Chyn Tsai Shih-Feng Liu Hui-Chuan Chang Ching-Min Huang Wan-Chun Hsieh Chin-Ling Li Ting-Lung Lin Ho-Chang Kuo |
| author_facet | Yuh-Chyn Tsai Shih-Feng Liu Hui-Chuan Chang Ching-Min Huang Wan-Chun Hsieh Chin-Ling Li Ting-Lung Lin Ho-Chang Kuo |
| author_sort | Yuh-Chyn Tsai |
| collection | DOAJ |
| description | The use of high-flow nasal cannula (HFNC) as an oxygen therapy post-extubation has demonstrated varying success rates across different surgical populations. This study aimed to identify the predictive factors influencing HFNC weaning outcomes in patients with postoperative extubation hypoxemia. We conducted a retrospective analysis of patients in a surgical intensive care unit, categorized into three major postoperative groups: cardiothoracic surgery, upper abdominal surgery, and other surgeries. Our analysis examined pre-extubation weaning profiles, vital signs before and after HFNC initiation, and changes in physiological parameters during HFNC use. A total of 90 patients were included, divided into two groups based on HFNC weaning success or failure. Key parameters analyzed included maximal inspiratory pressure (MIP), PaO<sub>2</sub>/FiO<sub>2</sub> (P/F) ratio, vital signs, SpO<sub>2</sub> levels, respiratory rate (RR), heart rate (HR), respiratory rate–oxygenation (ROX) index, and HFNC duration. The findings revealed that cardiothoracic and upper abdominal groups showed significantly higher HFNC weaning success rates (73.3% and 70.6%) compared to the other surgeries group (34.6%) (<i>p</i> = 0.004). Critical predictors of successful weaning included pre-HFNC SpO<sub>2</sub>, P/F ratio, and changes in the ROX index, particularly in upper abdominal and other surgeries groups. In cardiothoracic surgery patients, higher maximal inspiratory pressure (MIP) (<i>p</i> = 0.031) was associated with improved outcomes, while prolonged HFNC use correlated with weaning success in this group (<i>p</i> = 0.047). These findings underscore the necessity of tailoring HFNC strategies to surgical characteristics and individual patient profiles. For cardiothoracic surgery patients, pre-extubation MIP, post-extubation RR, ΔROX, and ΔHR were identified as key predictive factors. In upper abdominal surgery, pre-extubation P/F ratio, post-extubation SpO<sub>2</sub>, and ΔROX played crucial roles. For patients undergoing other types of surgeries, pre-extubation P/F ratio and ΔROX remained the most reliable predictors of HFNC weaning success. |
| format | Article |
| id | doaj-art-1b31d4bc41dd48ec8ac1a611cb80d16e |
| institution | DOAJ |
| issn | 2075-1729 |
| language | English |
| publishDate | 2025-02-01 |
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| spelling | doaj-art-1b31d4bc41dd48ec8ac1a611cb80d16e2025-08-20T03:12:00ZengMDPI AGLife2075-17292025-02-0115231210.3390/life15020312Tailored Predictive Indicators for Weaning Success from High-Flow Nasal Cannula in Postoperative Hypoxemic PatientsYuh-Chyn Tsai0Shih-Feng Liu1Hui-Chuan Chang2Ching-Min Huang3Wan-Chun Hsieh4Chin-Ling Li5Ting-Lung Lin6Ho-Chang Kuo7Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanDepartment of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanDepartment of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanDepartment of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanDepartment of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanDepartment of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanDivision of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung 833, TaiwanDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanThe use of high-flow nasal cannula (HFNC) as an oxygen therapy post-extubation has demonstrated varying success rates across different surgical populations. This study aimed to identify the predictive factors influencing HFNC weaning outcomes in patients with postoperative extubation hypoxemia. We conducted a retrospective analysis of patients in a surgical intensive care unit, categorized into three major postoperative groups: cardiothoracic surgery, upper abdominal surgery, and other surgeries. Our analysis examined pre-extubation weaning profiles, vital signs before and after HFNC initiation, and changes in physiological parameters during HFNC use. A total of 90 patients were included, divided into two groups based on HFNC weaning success or failure. Key parameters analyzed included maximal inspiratory pressure (MIP), PaO<sub>2</sub>/FiO<sub>2</sub> (P/F) ratio, vital signs, SpO<sub>2</sub> levels, respiratory rate (RR), heart rate (HR), respiratory rate–oxygenation (ROX) index, and HFNC duration. The findings revealed that cardiothoracic and upper abdominal groups showed significantly higher HFNC weaning success rates (73.3% and 70.6%) compared to the other surgeries group (34.6%) (<i>p</i> = 0.004). Critical predictors of successful weaning included pre-HFNC SpO<sub>2</sub>, P/F ratio, and changes in the ROX index, particularly in upper abdominal and other surgeries groups. In cardiothoracic surgery patients, higher maximal inspiratory pressure (MIP) (<i>p</i> = 0.031) was associated with improved outcomes, while prolonged HFNC use correlated with weaning success in this group (<i>p</i> = 0.047). These findings underscore the necessity of tailoring HFNC strategies to surgical characteristics and individual patient profiles. For cardiothoracic surgery patients, pre-extubation MIP, post-extubation RR, ΔROX, and ΔHR were identified as key predictive factors. In upper abdominal surgery, pre-extubation P/F ratio, post-extubation SpO<sub>2</sub>, and ΔROX played crucial roles. For patients undergoing other types of surgeries, pre-extubation P/F ratio and ΔROX remained the most reliable predictors of HFNC weaning success.https://www.mdpi.com/2075-1729/15/2/312hypoxemic respiratory failurehigh-flow nasal cannulapost-surgery |
| spellingShingle | Yuh-Chyn Tsai Shih-Feng Liu Hui-Chuan Chang Ching-Min Huang Wan-Chun Hsieh Chin-Ling Li Ting-Lung Lin Ho-Chang Kuo Tailored Predictive Indicators for Weaning Success from High-Flow Nasal Cannula in Postoperative Hypoxemic Patients Life hypoxemic respiratory failure high-flow nasal cannula post-surgery |
| title | Tailored Predictive Indicators for Weaning Success from High-Flow Nasal Cannula in Postoperative Hypoxemic Patients |
| title_full | Tailored Predictive Indicators for Weaning Success from High-Flow Nasal Cannula in Postoperative Hypoxemic Patients |
| title_fullStr | Tailored Predictive Indicators for Weaning Success from High-Flow Nasal Cannula in Postoperative Hypoxemic Patients |
| title_full_unstemmed | Tailored Predictive Indicators for Weaning Success from High-Flow Nasal Cannula in Postoperative Hypoxemic Patients |
| title_short | Tailored Predictive Indicators for Weaning Success from High-Flow Nasal Cannula in Postoperative Hypoxemic Patients |
| title_sort | tailored predictive indicators for weaning success from high flow nasal cannula in postoperative hypoxemic patients |
| topic | hypoxemic respiratory failure high-flow nasal cannula post-surgery |
| url | https://www.mdpi.com/2075-1729/15/2/312 |
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