• Mei Xia, Weina Li, Jie Yao, Ying Jin, Gaoli Du, Qianfeng Xu, Xing Yi, Xiaoxia Nv, Yi Wu, Ping He, and Wei Wu.
• Thoracic Surgery Department, Southwest Hospital, the First Hospital Affiliated to Army Medical University, Chongqing, China.
• Ann Palliat Med. 2021 Mar 1; 10 (3): 2530-2539.

BackgroundHypoxaemia in post-surgical patients of esophageal cancer (EC) is common in thoracic departments. However, few studies have investigated the role of high-flow nasal cannula (HFNC) compared with conventional oxygen therapy (COT).MethodsA retrospective study was implemented to enroll hypoxemic patients after esophagectomy who were treated by HFNC or COT immediately after extubation between January 2019 and December 2019. We compared the effect of HFNC or COT in patients regarding the vital signs and arterial blood gases, the incidence of anastomotic leakage, postoperative pulmonary complications (PPCs), sore throat/nose, and reintubation, length of stay, and sputum production. We also 3D reconstructed the postoperative chest CT, and compared the amount of lung volume loss caused by PPCs (pneumothorax, atelectasis, pulmonary consolidation and pleural effusion) between the two groups.ResultsCompared to patients in COT group, sore throat/nose in HFNC group was lower, the sputum production was higher, and the total hospital stay was shorter. Compared to COT, HFNC treatment decreased systolic blood pressure (SBP) at day 1, diastolic blood pressure (DBP) at day 1-4, and heart rate (HR) at day 2-4, increased arterial partial pressure of oxygen (PaO2) at day 1-4, and arterial oxygen saturation (SaO2%) at day 1-2. In addition, the rate of PPCs and anastomotic leakage in HFNC group were lower than those in COT group. Compared to COT, HFNC treatment significantly decreased the amount of lung volume loss caused by PPCs.ConclusionsHFNC can improve the hypoxemia of patients after esophagectomy, increase the flow of sputum, reduce the incidence of PPC and anastomotic leakage.

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