High flow nasal cannula effect on pulmonary complications after major elective upper abdominal surgeries: A randomized control study

Abstract

Background: Postoperative pulmonary complications (PPCs) are a challenge for anesthesiologists, especially following major surgeries. Using a high-flow nasal cannula (HFNC) postoperatively may decrease this challenge. Purpose: The study aimed to assess the clinical effect of HFNC after extubation compared with simple face mask oxygen following major elective upper abdominal surgeries regarding PPCs, the need to escalate the respiratory support, days of intensive care unit stay, and days of hospital stay. Methods: Eighty adult patients were randomly assigned to two groups (each with 40 patients): group I received HFNC, while group II received a standard oxygen face mask. Five days later, postoperative pulmonary problems were evaluated. Results: There was statistically significantly less lung atelectasis in the HFNC group than in the face mask group. The p-value was 0.029. There was no statistically significant difference concerning the need to escalate the respiratory support. The length of hospital and ICU stay days for the HFNC group was statistically significantly lower than for the face mask group. Conclusion: HFNC is more efficient than a simple oxygen face mask in lowering lung atelectasis following major upper abdominal procedures, improving oxygenation with decreasing respiratory rate and reducing ICU and hospital days of stay.