Abstract
This retrospective cohort study aims to evaluate the clinical effectiveness of high-flow nasal cannula oxygen therapy (HFNCO) in managing hypoxemia following cardiac surgery. Baseline characteristics were comparable between groups (P > .05). At 6 hours post-extubation, the HFNCO group demonstrated significantly lower respiratory rate (20.16 vs 22.19 breaths/min, P = .001), higher pH (7.42 vs 7.46, P = .001), reduced PaCO2 (36.66 vs 40.35 mm Hg, P = .001), and improved P/F ratio (298.05 vs 237.45, P < .001). High-flow nasal cannula oxygen therapy reduced intensive care unit length of stay (ICU LOS; 3.21 vs 7.32 days, P < .001), total hospital LOS (23.69 vs 33.07 days, P = .002), reintubation rate (2% vs 14%, P = .002), and ICU delirium incidence (5% vs 17%, P = .007). No mortality difference was observed (P > .05). High-flow nasal cannula oxygen therapy was associated with improved oxygenation, enhanced CO2 clearance, and a reduction in clinical complications in post-cardiac surgery hypoxemia. It may be a valuable alternative to conventional oxygen therapy, warranting further validation in multicenter trials. A total of 203 patients with hypoxemia (PaO2 < 60 mm Hg, SpO2 < 90%, or P/F ≤ 300 mm Hg) after cardiac surgery (January 2021-January 2024) were included. Participants were divided into conventional oxygen therapy (n = 101) and HFNCO (n = 102) groups. Primary outcomes included respiratory rate, blood gas parameters (pH, PaCO2, PaO2/FiO2), and secondary outcomes encompassed ICU/LOS, reintubation rate, and ICU-acquired delirium. Statistical analyses were performed using SPSS 26.0.