Respir Case Rep. 2019; 8(1): 35-39 | DOI: 10.5505/respircase.2019.47113

Hiperkapnik Solunum Yetmezliði ve Yüksek Akým Nazal Oksijen Tedavisi

Fatma Ýrem Yeþiler¹, Deniz Kosovalý², Ümit Gökhan Þendur³, Abdülhamit Sutukoðlu³, Mustafa Kemal Bayar^4
1Baþkent Üniversitesi Týp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalý, Yoðun Bakým Bilim Dalý, Ankara
²Malatya Eðitim Ve Araþtýrma Hastanesi, Yoðun Bakým Ünitesi, Malatya
³Þanlýurfa Eðitim Ve Araþtýrma Hastanesi, Ýç Hastalýklarý Kliniði, Þanlýurfa
⁴Ankara Üniversitesi Týp Fakültesi, Anesteziyoloji Ve Reanimasyon Anabilim Dalý, Yoðun Bakým Bilim Dalý, Ankara

Akut hipoksemik solunum yetmezlikli hastalarda, konvansiyonel oksijen tedavisi yerine son yýllarda ýsýtýlmýþ ve nemlendirilmiþ yüksek akýmda oksijenin nasal kanülle (HFNC) uygulanmasý popülarite kazanmýþtýr. Bu uygulama ile anatomik ölü boþluk, nazofaringeal direnç azalmasý, pozitif ekspiratuar basýnç etki ve alveoler rekrütment saðlanýr. Hastalarýn konforu ve toleransýný arttýrdýðý, solunum iþini ve sayýsýný azalttýðý ve deðiþik etyolojilere baðlý solunum yetersizliklerinde solunum desteðini arttýrma gereksinimini azalttýðý saptanmýþtýr. Hiperkapnik solunum yetmezlikli hastalarda da solunum iþini, solunum sayýsýný azalttýðýný, ventilasyon etkinliðini, tidal volümü ve egzersiz toleransýný arttýrdýðýný gösteren çalýþmalar mevcuttur. Ýki olgumuzu da kronik obstrüktif akciðer hastalýðýna baðlý hiperkapnik solunum yetmezliðinde noninvaziv mekanik ventilasyon tedavisinin etkin olmadýðý durumlarda yüksek akýmda oksijenin nasal kanülle uygulanmasýnýn etkinliðini göstermek ve kullanýmýna yönelik farkýndalýðý arttýrmak amacýyla sunuyoruz.

Anahtar Kelimeler: Hiperkapnik solunum yetmezliði, tip 2 solunum yetmezliði, kronik obstrüktif akciðer hastalýðý (KOAH), obstrüktif akciðer hastalýðý, yüksek akým nasal oksijen (HFNC)

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Hypercapnic Respiratory Failure and High Flow Nasal Oxygen Therapy

Fatma Ýrem Yeþiler¹, Deniz Kosovalý², Ümit Gökhan Þendur³, Abdülhamit Sutukoðlu³, Mustafa Kemal Bayar^4
1Department of Anesthesiology and Reanimation, Intensive Care Unit, Baskent University, Ankara, Turkey
²Department Of Intensive Care Unit, Malatya Education And Research Hospital, Malatya,turkey
³Department Of Internal Medicine, Sanliurfa Education And Research Hospital, Sanliurfa, Turkey
⁴Department Of Anesthesia And Reanimation, Intensive Care Unit, Ankara University, Ankara, Turkey

The use of heated and humidified high-flow nasal cannula oxygen (HFNC) is increasingly popular in place of conventional oxygen therapy for patients with acute hypoxemic respiratory failure. HFNC oxygen rapidly alleviates symptoms of respiratory distress and the effort to breathe through several mechanisms, including dead space washout, reduction in inspiratory nasopharyngeal resistance, and a positive airway pressure effect that may generate alveolar recruitment. HFNC oxygen increases the comfort and tolerance of patients and reduces the requirement for respiratory support in patients with respiratory failure. Several studies have shown that HFNC oxygen may also reduce breathing effort and respiratory rate, and increase alveolar ventilation, tidal volume, and exercise tolerance in patients with hypercapnic respiratory failure. Presently described are 2 cases in which a HFNC system was used to successfully manage hypercapnic respiratory failure secondary to chronic obstructive pulmonary disease in 2 patients unable to tolerate conventional noninvasive mechanical ventilation. This report is presented in order to draw attention to the use of HFNC oxygen in patients with hypercapnic respiratory failure.

Keywords: Hypercapnic respiratory failure, Type 2 respiratory failure, chronic obstructive pulmonary disease (COPD), obstructive pulmonary disease, high flow nasal oxygen (HFNC)

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