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A prospective study on use of thrive (transnasal humidified rapid insufflation ventilatory exchange) versus conventional nasal oxygenation following extubation of adult cardiac surgical patients


1 Department of Cardiac Anesthesia, SRM Institute of Medical Sciences, Chennai, India
2 Department of Anesthesia, Apollo Institute of Medical Sciences and Research, Chittor, Andhra Pradesh, India
3 Department of Anesthesia, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India

Correspondence Address:
V Manjunath
Assistant Professor, Sri Jayadeva Institute Of Cardiovascular Sciences and Research, Bangalore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_16_20

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Year : 2021  |  Volume : 24  |  Issue : 3  |  Page : 353-357

 

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Background: Postoperative pulmonary complications in cardiac surgery increase mortality and morbidity. High flow nasal cannula oxygen therapy (HFNC) is one of the preventive measures to reduce the incidence of lung complications. HFNC can decrease dyspnea and improve physiologic parameters after extubation, including respiratory rate and heart rate, compared with conventional oxygen therapy. In this study, we evaluated the role of THRIVE (Transnasal Humidified Rapid Insufflation Ventilatory Exchange) after extubation. Methodology: We prospectively randomized 60 adults aged between 18 and 65 years undergoing elective cardiac surgery to either High flow oxygen therapy using THRIVE (Group A) or conventional nasal cannula (group B). Arterial paO2, paCO2, pH at three points of time i.e., 1, 2, 4 hrs after extubation were evaluated using arterial blood gas analysis. Ventilation duration, the incidence of reintubation, sedation score, mortality, and other complications were also assessed. Results: Thirty adults in each group had comparable patient characteristics. There was a statistically significant decline in paCO2 in group A at 1, 2, 4 hrs post extubation (P = 0.022, 0.02, <0.001) with a significant increase in oxygenation (P < 0.001) when compared to group B.ICU stay duration was similar between two groups. No complications were noted in both groups. Conclusion: THRIVE is safe to use following extubation in adult cardiac surgical patients.






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1 Department of Cardiac Anesthesia, SRM Institute of Medical Sciences, Chennai, India
2 Department of Anesthesia, Apollo Institute of Medical Sciences and Research, Chittor, Andhra Pradesh, India
3 Department of Anesthesia, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India

Correspondence Address:
V Manjunath
Assistant Professor, Sri Jayadeva Institute Of Cardiovascular Sciences and Research, Bangalore, Karnataka
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_16_20

Rights and Permissions

Background: Postoperative pulmonary complications in cardiac surgery increase mortality and morbidity. High flow nasal cannula oxygen therapy (HFNC) is one of the preventive measures to reduce the incidence of lung complications. HFNC can decrease dyspnea and improve physiologic parameters after extubation, including respiratory rate and heart rate, compared with conventional oxygen therapy. In this study, we evaluated the role of THRIVE (Transnasal Humidified Rapid Insufflation Ventilatory Exchange) after extubation. Methodology: We prospectively randomized 60 adults aged between 18 and 65 years undergoing elective cardiac surgery to either High flow oxygen therapy using THRIVE (Group A) or conventional nasal cannula (group B). Arterial paO2, paCO2, pH at three points of time i.e., 1, 2, 4 hrs after extubation were evaluated using arterial blood gas analysis. Ventilation duration, the incidence of reintubation, sedation score, mortality, and other complications were also assessed. Results: Thirty adults in each group had comparable patient characteristics. There was a statistically significant decline in paCO2 in group A at 1, 2, 4 hrs post extubation (P = 0.022, 0.02, <0.001) with a significant increase in oxygenation (P < 0.001) when compared to group B.ICU stay duration was similar between two groups. No complications were noted in both groups. Conclusion: THRIVE is safe to use following extubation in adult cardiac surgical patients.






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