Abstract:

Objective To investigate the risk factors associated with failure of nasal high⁃flow nasal oxy⁃ gen therapy（HFNC）in hypoxic respiratory failure patients after non⁃cardiac surgery. Methods This retrospective study was conducted at Peking University People′s Hospital. The subjects included all patients who suffering hypoxic respiratory failure after non⁃cardiac surgery from January 2016 to December 2019. Clinical and laboratory parame⁃ ters use statistical methods to explore the risk factors involved in HFNC failure and establish an early warning model. Results A total of 133 patients were included. According to HFNC failure criteria，patients were divided into HFNC failure group（n = 40）and success group（n = 93）. Multivariate analysis showed that patient with temperature （T）> 37.3 ℃，high acute physiology and chronic health status score Ⅱ（APACHⅡ）score，cardiac troponinⅠ （TNI ）level before using HFNC，and low ROX（SpO2/FiO2/RR）< 8 at 1 hour after treatment were independent risk factors for HFNC failure；a regression model was established：Y = -2.158 + 1.882 × fever + 0.283 × APACHⅡ- 0.326 × ROX + 2.222 × TNI，the area under the ROC curve（AUC）of the model is 0.915（P < 0.01）. Conclusions Hypoxic respiratory failure patients after non⁃cardiac surgery fever，High APACHII score and TNI level at baseline are indicate a higher risk of HFNC failure. ROX is still lower after 1 h treatment an important indicator for further mechanical ventilation，the treatment strategy should be adjusted in time.

Key words:

High?flow nasal cannula oxygen therapy, non?cardiac surgery, hypoxic respiratory failure, failure, risk factors