Background

Acute hypoxemic respiratory failure (ARF) is characterized by both lower arterial oxygen and carbon dioxide tensions in the blood. First line treatment for ARF includes oxygen therapy – intially administered non invasively using nasal prongs, high flow nasal cannulae (HFNC) or masks. Invasive mechanical ventilation (IMV) is usually reserved for patients who are unable to maintain their airway, those with worsening hypoxemia, or those who develop respiratory muscle fatigue and consequent hypercapnia. Inhaled nitric oxide (iNO) gas is known to improve oxygenation in patients with ARF by manipulating ventilation-perfusion matching. Addition of iNO may potentially alleviate the need for IMV in selected patients.

Case summary

In this article we report our preliminary experience of using HFNC to deliver oxygen and nitric oxide gas in patients with hypoxemic ARF as a strategy to potentially avoid IMV in selected patients.

Conclusion

This article demonstrates the feasibility of this technique based on our experience of patients with hypoxemic ARF and generates hypothesis for future studies.

中文翻译：

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无创一氧化氮气体吸入预防急性低氧性呼吸衰竭患者气管插管的可行性：单中心经验

背景

急性低氧性呼吸衰竭 (ARF) 的特征是血液中的动脉氧和二氧化碳张力较低。ARF 的一线治疗包括氧疗——最初使用鼻尖、高流量鼻导管 (HFNC) 或面罩进行非侵入性治疗。有创机械通气 (IMV) 通常用于无法维持气道的患者、低氧血症恶化的患者或出现呼吸肌疲劳和随之而来的高碳酸血症的患者。众所周知，吸入一氧化氮 (iNO) 气体可通过控制通气-灌注匹配来改善 ARF 患者的氧合。添加 iNO 可能会潜在地减轻选定患者对 IMV 的需求。

案例总结

在本文中，我们报告了我们使用 HFNC 为低氧性 ARF 患者输送氧气和一氧化氮气体的初步经验，作为潜在避免选定患者 IMV 的策略。

结论

本文根据我们对低氧性 ARF 患者的经验证明了这种技术的可行性，并为未来的研究提出了假设。