醫學雜誌

台灣急重症醫學雜誌

Volume 8, Number 2, June2023

Original Articles 原著

The Use of High-Flow Nasal Oxygen in Cancer Patients

Hsieh-Ting Lin, Chung-Jen Huang

Background: High-flow nasal cannula (HFNC) is a state-of-the-art respiratory support technique which delivers high flow, heated and humidified controlled concentration of oxygen via the nasal route. However, there are few data about its use in cancer patient, especially in patient with DNR/DNI coding.

Method: A retrospective study to evaluate the efficacy, safety, and tolerability of HFNC therapy for cancer patients was performed in a single cancer center.

Result: Twenty-nine patients underwent HFNC therapy from 2014 to 2021 were enrolled. The cancer diagnosis was mainly lung cancer (n = 14) and esophageal cancer (n = 4). Most patients showed a good response to HFNC therapy. There are 13 patients with the code of DNR/DNI, and 10 patients was supported by HFNC till the end of life. Most patients and health care providers are satisfied with the quality of life in the difficult period.

Conclusion: High flow nasal cannula provides good respiratory support for patients with hypoxemic respiratory failure and may be an alternative to NIV (noninvasive ventilation) for DNI patients when considering the quality of life. High flow nasal cannula is safe and effective in different scenarios and can be used for palliative cancer care or post-op unstable cancer patients.

Keyword:  high flow nasal cannula, cancer care, noninvasive ventilation

高流量鼻導管氧氣在癌症病人的使用

林協霆,黃崇仁

背景:高流量鼻導管是一種比較進步的給氧技術,通過鼻腔途徑提供高流量,加熱和加濕的準確控制濃度的氧氣。然而,關於其在癌症患者中使用的數據並不多,特別是在拒絕心肺復甦術及拒絕氣管插管病人中。

方法:在一個癌症醫院進行一項回溯性研究,以評估高流量鼻導管氧氣治療癌症患者的有效性,安全性和耐受性。

結果:2014 年至 2021 年接受 HFNC 治療的患者為 29 例。癌症診斷主要是肺癌(n=14)和食道癌(n=4)。大多數患者對 HFNC 治療表現出良好的反應。有 13 名病人是 DNR / DNI 病人,10 名患者使用高流量鼻導管氧氣直到生命結束。大多數病人和醫護人員對於使用高流量鼻導管的生活品質感到滿意。

結論:高流量鼻導管氧氣為低氧血症呼吸衰竭患者提供良好的呼吸支持,在考慮生活品質時,高流量鼻導管氧氣可以是 DNI 患者使用非侵襲性呼吸器的替代方法。對於接受安寧照顧或手術後不穩定的癌症病人都可以提供很好的氧氣照顧。

關鍵詞: 高流量鼻導管氧氣,癌症照顧,非侵襲性呼吸器
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