Raw data of HFNC vs NP in elderly orthopaedic surgery

Abstract

Background: Elderly patients posed a significant challenge to anaesthetist due to decline in functional reserve leading to complications including hypoxaemia.

Methods: A randomised controlled study where patients ≥60 years undergoing orthopaedic surgeries under combined spinal epidural were recruited and randomised to receive oxygen support either through High flow nasal cannula (HFNC) or Nasal prong (NP). Parameters in arterial blood gas analysis were monitored at pre-intervention, intraoperative and 30 minutes post cessation of therapy. Perioperative hypoxaemia was the primary outcome with length of stay (LOS), patient comfort, and incidence of postoperative pulmonary complications (PPCs) recorded as secondary outcomes.

Results: A total of 50 patients were studied, with 24 randomised into receiving HFNC; 26 received NP. The mean total duration of oxygen therapy was 192 vs 170 minutes in the HFNC vs NP group. Intraoperative hypoxaemia occurred in 12.5% vs 19.2%, and postoperative hypoxaemia in 16.7% vs 7.7% in HFNC vs NP group respectively. The incidence of PPCs was 45.8% vs 57.7% in HFNC vs NP group. However, none of these findings are statistically significant. The mean LOS was 17.9 days in HFNC while 12.7 days in the NP patients (P=0.467). Patients in both groups expressed similar comfort level towards the oxygen therapy.

Conclusion: Intraoperative oxygen supplement via HFNC in patients receiving CSE offers no extra benefit in preventing perioperative hypoxaemia, PPC or reducing the total LOS.