The use of high-flow nasal oxygen vs. standard oxygen therapy in hematological malignancy patients with acute respiratory failure in hematology wards

Turk J Med Sci. 2021 Aug 30;51(4):1756-1763. doi: 10.3906/sag-2007-228.

Abstract

Background/aim: High flow nasal cannula (HFNC) was mostly used in intensive care units (ICUs) with few studies in other departments. We hypothesized that HFNC applied at wards is beneficial for acute respiratory failure in hematological malignancy patients.

Materials and methods: The study is a single center, randomized controlled study. Inclusion criteria were hypoxemic respiratory failure and hematological malignancy. Patients were randomized to either venturi mask/nasal cannula oxygen treatment or HFNC.

Results: One hundred patients were included in the study. Median age was 58.5 (18–86) years and APACHE II score was 17 (5–29). HFNC group was 51 patients and the oxygen treatment group 49 patients. P/F ratios were similar between the groups throughout the study period. Endotracheal intubation was required in 10 (20.0%) patients in oxygen group and 17 (33.0%) patients in HFNC group (p = 0.14). A total of 17 (35.0%) patients in oxygen group and 17 (33.0%) patients in HFNC group received noninvasive mechanical ventilation (p = 0.97). Median VAS comfort scores at the 2nd and 24th hours were not different between groups. The 28-day mortality rate was 36.7% (18 deaths) in the standard group and 45.0% (23 deaths) in the HFNC group (p = 0.39).

Conclusion: HFNC applied in wards is not superior to standard oxygen treatment for acute respiratory failure in hematological malignancy patients.

Keywords: Acute respiratory failure; high flow nasal oxygen; hematological malignancy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Female
  • Hematologic Neoplasms / complications*
  • Hematologic Neoplasms / epidemiology
  • Hematologic Neoplasms / therapy
  • Humans
  • Male
  • Middle Aged
  • Noninvasive Ventilation / methods*
  • Oxygen / therapeutic use*
  • Oxygen Inhalation Therapy / methods*
  • Respiratory Distress Syndrome
  • Respiratory Insufficiency / epidemiology
  • Respiratory Insufficiency / etiology
  • Respiratory Insufficiency / therapy*
  • Treatment Outcome

Substances

  • Oxygen