Raw data of HFNC vs NP in elderly orthopaedic surgery

<b>Abstract</b><b>Background: </b>Elderly patients posed a significant challenge to anaesthetist due to decline in functional reserve leading to complications including hypoxaemia.<b>Methods: </b>A randomised controlled study where patients ≥60 years undergoing orthopaedic surgeries under combined spinal epidural were recruited and randomised to receive oxygen support either through High flow nasal cannula (HFNC) or Nasal prong (NP). Parameters in arterial blood gas analysis were monitored at pre-intervention, intraoperative and 30 minutes post cessation of therapy. Perioperative hypoxaemia was the primary outcome with length of stay (LOS), patient comfort, and incidence of postoperative pulmonary complications (PPCs) recorded as secondary outcomes.<b>Results:</b> A total of 50 patients were studied, with 24 randomised into receiving HFNC; 26 received NP. The mean total duration of oxygen therapy was 192 vs 170 minutes in the HFNC vs NP group. Intraoperative hypoxaemia occurred in 12.5% vs 19.2%, and postoperative hypoxaemia in 16.7% vs 7.7% in HFNC vs NP group respectively. The incidence of PPCs was 45.8% vs 57.7% in HFNC vs NP group. However, none of these findings are statistically significant. The mean LOS was 17.9 days in HFNC while 12.7 days in the NP patients (P=0.467). Patients in both groups expressed similar comfort level towards the oxygen therapy.<b>Conclusion:</b> Intraoperative oxygen supplement via HFNC in patients receiving CSE offers no extra benefit in preventing perioperative hypoxaemia, PPC or reducing the total LOS.<br>

摘要

## 研究背景：老年患者因功能储备下降，易出现包括低氧血症在内的多种并发症，对麻醉医师而言是一项重大挑战。

## 研究方法：本研究为随机对照研究，纳入年龄≥60岁、拟行腰硬联合麻醉（combined spinal epidural, CSE）下骨科手术的患者，将其随机分配至经鼻高流量氧疗（High flow nasal cannula, HFNC）组或鼻导管吸氧（Nasal prong, NP）组接受氧支持。分别于干预前、术中及停止氧疗后30分钟监测动脉血气分析相关指标。以围术期低氧血症为主要结局指标，记录住院时长（length of stay, LOS）、患者舒适度及术后肺部并发症（postoperative pulmonary complications, PPCs）作为次要结局指标。

## 研究结果：本研究共纳入50例患者，其中24例被分配至HFNC组，26例分配至NP组。HFNC组与NP组的平均氧疗总时长分别为192分钟与170分钟。HFNC组术中低氧血症发生率为12.5%，NP组为19.2%；术后低氧血症发生率分别为16.7%与7.7%。HFNC组术后肺部并发症发生率为45.8%，NP组为57.7%，但上述差异均无统计学意义。HFNC组平均住院时长为17.9天，NP组为12.7天（P=0.467）。两组患者对氧疗的舒适度评价无显著差异。

## 研究结论：对于接受CSE的老年患者，术中经HFNC给予氧补充，在预防围术期低氧血症、术后肺部并发症或缩短总住院时长方面均无额外获益。