Therapeutic effects and the influence on serum inflammatory factors of high-flow nasal cannula oxygen therapy in senior patients with lower respiratory tract infections

Abstract

BACKGROUND:

Lower respiratory tract infection (LRTI) is a clinical multi-infectious disease caused by viral, bacterial, and other microbial infections.

OBJECTIVE:

The present study aims to explore the therapeutic effects of high-flow nasal cannula (HFNC) oxygen therapy and its influence on the serum levels of inflammatory factors in senior patients with LRTI.

METHODS:

In this randomized controlled trial, 84 senior patients with LRTI were enrolled between March 2017 and December 2019 and divided into the observation group and the control group according to the random number table method, with 42 cases in each group. Conventional nasal cannula (CNC) oxygen therapy was conducted in the control group and HFNC was conducted in the observation group. After 3 days of treatment, sputum properties, sputum volume, sputum viscosity, and sputum crust formation were recorded to determine the clinical efficacy. ELISA was performed to detect the serum levels of tumor necrosis factor alpha (TNF- $\alpha$ ) and interlukein (IL)-8 before and after treatment.

RESULTS:

The total efficacy in the observation group was 92.86%, which was higher than in the control group (73.81%) ( $P<$ 0.05). Three days after treatment, the percentage of grade I sputum in the observation group (73.81%) was higher than in the control group (40.48%). Moreover, the percentage of grade II sputum (23.81%), the percentage of grade III sputum (2.38%), together with the sputum crust formation rate in the observation group (4.76%) were all lower than in the control group (45.24, 14.28, and 26.19%, respectively) ( $P<$ 0.05). Three days after treatment, the levels of IL-8 (0.21 $\pm$ 0.03 pg/L) and TNF- $\alpha$ (1.27 $\pm$ 0.14 ng/L) in the observation group were lower than in the control group (0.30 $\pm$ 0.04 pg/L, and 1.49 $\pm$ 0.18 ng/L) ( $t=$ 6.525, 11.665, 6.252, respectively; $P<$ 0.05).

CONCLUSION:

The application of HFNC in senior patients with LRTI could improve respiratory humidification, reduce the number of sputum aspirations, and improve anti-inflammatory effects. It is worthy of application in elderly patients with LRTI.