Solunum Yetersizliğinde Yüksek Akım Oksijen Tedavisi

ÖzYüksek akımlı oksijen tedavisi, orta ciddiyetteki solunum yetersizliğinde invazif mekanik ventilasyon gereksinimini azaltan yeni tedavi yaklaşımlarındandır. Yaşları 3 ay ile 3 yaş arasında değişen akut solunum yetersizliği tanılı beş hastada yüksek akımlı oksijen tedavisi uyguladık. Üç olgu bronşiyolit, bir olgu gazyağı alımı sonrası gelişen şimik pnömoni ve bir olgu da sol ventrikül çıkım yolu darlığı ve akciğer ödemi tablosunda idi. Tedavi başlangıcında ortalama akım hızı 8-10 L/dakika (maksimum 15 L/dakika) ve fraksiyone inspiratuvar oksijen konsantrasyonu %40 olarak uygulandı. Tedavi ikinci saatinde kalp hızı ve solunum hızında sırasıyla %20, %27azalma, SpO2/FiO2 oranında %93 artış oldu. Yüksek akımlı oksijen tedavisi ortalama 3.6 gün uygulandı.Sonuçlar:Yüksek akımlı oksijen tedavisi orta ciddiyetteki hipoksemik solunum yetersizliğinde güvenle uygulanabilir. Tedavi etkinliğini gösteren önemli değişkenler, kalp tepe atımı ve dakika solunum sayısında azalma ve SpO2/FiO2oranında artıştır.

Anahtar Kelimeler:

Yüksek Akım Oksijen, NazalKanül, Hipoksemik SolunumYetersizliği

High Flow Oxygen Therapy In Respiratory Failure

AbstractHigh-flow nasal cannula oxygen therapy is one of the new treatment modalities thatreduce to need for invasive mechanical ventilation in moderate hypoxemic respiratoryfailure. High flow oxygen therapy was performed in three patients with acute bronchiolitis, one patient with severe left ventricular outflow tract obstruction and pulmonary edema and one patient with chemical pneumonia secondary to paraffin oil ingestion. The ages of the patients were between 3 months to 3 years. At the beginning oftherapy, the flow rate was generally set as 8-10 L per min (maximum: 15 L per min)and the fraction inspiratory oxygen concentration was set as 40%. At the second hourof high flow oxygen therapy heart rate and respiratory rate was decreased 20% and 27%,respectively. There was 93% improvement in SpO2/FiO2 at the second hour of therapy.Duration of treatment was 3.6 days.Conclusions:High flow oxygen therapy should safely consider in the management of moderate hypoxemic respiratory failure. The most important approach during high flow oxygen therapy is monitoring the improvement in vital signs and SpO2/FiO2ratio especially atthe first hours of treatment.

Keywords:

High Flow Oxygen, NasalCannula, Hypoxemic Respiratory Failure,

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