6/30/23, 12:50 AM Zochios Pathway Feedback Search Clinical Topics Home Studies Zochios Zochios Disease Disease Disease Aortic regurgitation Aortic stenosis Corona Trial question What is the effect of prophylactic high-flow nasal oxygen use in cardiac surgical patients at high risk for postoperative respiratory complications? Study design Multi-center Open label RCT Population Characteristics of study participants 38.3% female N = 100 61.7% male 100 patients (36 female, 58 male) Inclusion criteria: adult patients with pre-existing respiratory disease undergoing elective cardiac surgery Key exclusion criteria: presence of a nasal septal defect, need for CPAP therapy pre operatively or unmet criteria for tracheal extubation the day after surgery Interventions N=51 high-flow nasal oxygen (the FiO2 titrated to provide oximetry saturation of at least 95% (93% for those at risk of hypercapnic respiratory failure); standard starting flow rate of 30 L/min) N=49 standard oxygen therapy (low flow oxygen via nasal prongs or a soft facemask titrated to provide oximetry saturations of at least 95% (93% for those at risk of hypercapnic respiratory failure)) P i t https://web.pathway.md/studies/recyYBmxos7damBAQ 1/2 6/30/23, 12:50 AM Zochios Pathway Primary outcome Total length of hospital stay 9.0 days 9 7 6.8 days 4.5 days 2.3 days Significant decrease 0.0 days High-flow nasal oxygen Standard oxygen therapy Significant decrease in the total length of hospital stay (7 days vs. 9 days; AD -2 days, 95% CI -3.56 to -0.44) Secondary outcomes Significant decrease in re-admission to ICU (2% vs. 15.6%; RR 0.13, 95% CI 0.02 to 0.24) No significant difference in mean postoperative six-minute walk test (207.3 m vs. 186.1 m; AD 21.3 m, 95% CI -44 to 86.6) No significant difference in FEV in one second (1.5 vs. 1.2; AD 0.3, 95% CI -0.14 to 0.74) Safety outcomes No significant difference in extra-pulmonary postoperative complications. Conclusion In adult patients with pre-existing respiratory disease undergoing elective cardiac surgery, high- flow nasal oxygen was superior to standard oxygen therapy with respect to the total length of hospital stay. Reference V Zochios, T Collier, G Blaudszun et al. The effect of high-flow nasal oxygen on hospital length of stay in cardiac surgical patients at high risk for respiratory complications: a randomised controlled trial. Anaesthesia. 2018 Dec;73(12):1478-1488. Open reference URL https://web.pathway.md/studies/recyYBmxos7damBAQ 2/2