High-flow nasal oxygen in high risk cardiac surgical patients
Research type
Research Study
Full title
A randomised controlled trial of high-flow nasal oxygen (Optiflow™) and standard oxygen therapy in high-risk patients after cardiac surgery.
IRAS ID
181388
Contact name
Vasileios Zochios
Contact email
Duration of Study in the UK
0 years, 6 months, 1 days
Research summary
Patients post cardiac surgery are at risk of respiratory complications, and consequently prolonged length of hospital stay, delayed recovery and poorer outcomes. The incidence of respiratory complications is increased in patients with previous respiratory disease such as asthma or chronic obstructive pulmonary disease (COPD), or current smokers. Non-invasive positive pressure ventilation (NIV) is one therapy which when administered prophylactically can improve functional performance and decrease respiratory complications. Use of prophylactic NIV therapy is however often limited by increased staffing and monitoring requirements, and in many centres cannot be administered outside of an intensive care or high dependency unit. Nasal high flow oxygen (NHFO) is capable of providing a low level of continuous pressure which helps patients to breathe more efficiently, and may provide the benefits of NIV to post cardiac surgery high risk patients, in a manner simple and convenient enough to use on a standard postoperative ward. We have shown that use of NHFO immediately after thoracic lung resection surgery, in the recovery and for 24 hours after surgery, reduces hospital length of stay and improves functional patient-reported recovery. A previous study has shown that NHFNO did not improve outcomes as assessed by oxygen saturations in low-risk patients after cardiac surgery. We therefore plan to study high-risk patients, who we expect to stay longer in the intensive care unit and hospital due to increased respiratory complications. Our hypothesis is that prophylactic use of nasal high flow oxygen in high-risk cardiac surgical patients for 24 hours after surgery will reduce the length of hospital stay and improve functional patient-reported recovery.Improved functional recovery may be associated with fewer respiratory complications and may subsequently lead to earlier discharge from hospital. We will also measure patients' lung function tests before and after their surgery, and evaluate their recovery using an established perioperative questionnaire.
REC name
East Midlands - Derby Research Ethics Committee
REC reference
15/EM/0251
Date of REC Opinion
9 Jun 2015
REC opinion
Favourable Opinion