Comparative Study of High-Flow Nasal Cannula vs. Invasive Mechanical Ventilation in Early ARDS Management

Abstract

Background: acute respiratory distress syndrome (ARDS) is a severe lung condition associated with high mortality. Early management strategies significantly influence patient outcomes. Objective: To compare the efficacy of High-Flow Nasal Cannula (HFNC) versus Invasive Mechanical Ventilation (IMV) in the early management of ARDS in a hospital setting. Methods: A prospective study was conducted at Rajshahi Medical College Hospital from June 2022 to December 2023. A total of 126 patients diagnosed with ARDS were randomly assigned to receive either HFNC or IMV. The primary outcome measured was the intubation rate, and secondary outcomes included oxygenation improvement, ICU length of stay, and complications. Statistical analysis included the calculation of means, standard deviations, and p-values to assess the significance of the differences observed between groups. Results: The study showed that 62 patients in the HFNC group had an intubation rate of 21%, whereas 64 patients in the IMV group had an intubation rate of 35%. The mean PaO2/FiO2 ratio improved by 14% more in the HFNC group compared to IMV (p < 0.05). Oxygenation improvements were statistically significant in the HFNC group, with a standard deviation of 5.8, compared to 9.4 in the IMV group. The ICU stay was shorter in the HFNC group (6.5 days) compared to the IMV group (8.2 days), with a p-value of 0.02. The incidence of ventilator-associated pneumonia was lower in the HFNC group at 5% versus 12% in the IMV group. Conclusion: HFNC was found to be as effective as IMV in the early management of ARDS, offering advantages in reducing intubation rates and ICU length of stay with fewer complications.