Impact of nasal high-flow humidified oxygen therapy on oxygenation index and respiratory function in patients with Stanford Type B aortic dissection and hypoxemia.

Abstract

Objective: To evaluate the efficacy of nasal high-flow humidified oxygen therapy (HFHO) in improving oxygenation and respiratory function.

Methods: This retrospective analysis included 193 patients with Stanford Type B aortic dissection and hypoxemia admitted to Xingtai People's Hospital from January 2020 to January 2023. Patients were divided into two groups: HFHO (n = 107) and conventional oxygen therapy (CO, n = 125). The primary endpoints included changes in the oxygenation index (PaO₂/FiO₂), respiratory parameters, and Radiological Atelectasis Score (RAS). Secondary outcomes included re-intubation rates, ICU length of stay, and overall hospital stay duration.

Results: Baseline demographic and disease characteristics were similar between groups (all P > 0.05). The HFHO group displayed a significant improvement in PaO₂/FiO₂ post-treatment (225.55 ± 3.28 mmHg) compared to the CO group (224.56 ± 2.31 mmHg; P = 0.010). The HFHO group also had a significantly lower respiratory rate (24.71 ± 0.89 bpm; P = 0.038) and higher SpO₂ (90.92% ± 0.93%; P < 0.001) post-treatment. Additionally, HFHO was associated with a lower re-intubation rate (6.54% vs 17.6%; P = 0.011) and shorter ICU (3.88 ± 0.63 days; P = 0.023) and hospital stays (10.57 ± 0.6 days; P = 0.004). The RAS significantly improved in the HFHO group by days 3-5 post-operation (1.17 ± 0.3; P = 0.008).

Conclusion: HFHO offers superior outcomes in oxygenation and respiratory function compared to conventional oxygen therapy in patients with Stanford Type B aortic dissection and hypoxemia.