evaluating the valuable effects of oxygen therapy by high-fidelity human patient simulator

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K10544
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Anesthesiology
• Research Institution: Kyorin University
• Principal Investigator: Moriyama Kiyoshi 杏林大学, 医学部, 准教授 (10296717)
• Co-Investigator(Kenkyū-buntansha): 萬 知子 杏林大学, 医学部, 教授 (40210801) ; 本保 晃 杏林大学, 医学部, 助教 (10625578)
• Research Collaborator: OKANO Hiromu
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: 高機能シミュレーター / 経鼻高流量酸素療法 / 急性呼吸不全 / 高流量酸素療法 / 集中治療 / 呼吸仕事量

Outline of Final Research Achievements

The high-flow nasal cannula (HFNC) therapy is currently used to avoid endotracheal intubation in patients with severe hypoxemic respiratory failure. HFNC seems beneficial to patients with nonhypercapnic acute hypoxemic respiratory failure, to hypoxemic patients after cardiothoracic surgery, and to post-extubated patients with low risk for reintubation.
We investigated the beneficial effects of HFNC therapy to reduce work of breathing in the simulator study and the clinical study. In the simulator study, we showed that HFNC therapy reduced PaCO2, respiratory rates and minute volumes simultaneously. In the clinical study, we showed that HFNC therapy reduced respiratory rates and heart rates, while oxygenation as assessed by S/F ratio did not change. We also found that HFNC was used in an elderly population with moderate to severe respiratory failure, including a number of Do-not-intubate patients, as an alternative oxygen therapy to reduce suffering at the end of life.

Free Research Field

急性呼吸不全

Academic Significance and Societal Importance of the Research Achievements

これまでの知見ではNHFが呼吸を補助する効果が判然としないため、その適応が集中治療領域に限られてきた。本研究の結果及び近年の臨床研究で得られたその他の知見より、NHFの適応拡大により多くの呼吸不全の患者に利益がもたらされる可能性を示した。
非侵襲的に呼吸状態を改善できる酸素療法器具の適応拡大は、今後増加する可能性が高い高齢者の呼吸不全への人工呼吸の必要性を減らすことで、患者の苦痛を減らすとともに医療費を削減し、本邦の医療に貢献すると考える。