Yüksek akımlı nazal kanül ile noninvaziv mekanik ventilasyon yöntemlerinin ekstübasyon ve mekanik ventilasyon desteğinin kesilmesi süreçlerindeki etkinliklerinin karşılaştırılması.
Çelik Ertaş, Nur Berna
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Failed extubation; causing reintubation and an increase in prolonged length of stay in mechanical ventilator, intensive care unit and hospital, costs, resulting in increased morbidity and mortality. In individuals with comorbid conditions with such as neuromuscular and cardiac diseases, airway abnormalities due to medical and surgical reasons, prolonged intubation induced laryngeal damage incidence has increased. Besides the support with oxygen mask after extubation, noninvasive mechanical ventilation (NIMV) and in the last period high flow nasal cannula (HFNC) is used in order to increase the success of extubation. High-flow nasal cannula are used in neonatal intensive care units in particular, while the field of use in children's units began more recently and it has been especially limited to children with bronchiolitis. This study aimed to investigate the comparison of NIMV with HFNC in order to evaluate the extubation success. The studies in the literature on this subject includes adult patient groups. Twenty four patients who were applied NIMV between november 2009-february 2015 and 36 patients who were applied HFNC between february 2015-february 2016 were enrolled in the study. Patients’ demographic characteristics, comorbid diseases, intubation causes, PRISM (Pediatric Risk of Mortality Score) and PELOD (Pediatric Logistic Organ Disfunction) scores, oxygenation index, inotropic score, mechanical ventilation length of stay, mechanical ventilation modes, ICU and hospital length of stay, during follow-up in HFNC and NIMV modified Downes-Silverman Score (MDS) and complications such as reintubation, tracheostomy, mortality were investigated. There was no significant difference between txo groups in extubation success (p=0.167), tracheostomy (p=1.0) and mortality rates (p=1.0), length of stay in intensive care (p=0.215) and in 48 hours change in blood gas parameters and the MDS scores (p=0.809). HFNC can be used as an alternative of NIMV to enhance extubation success.