Clinical observation of extracorporeal diaphragmatic pacemaker combined with transnasal high flow oxygen therapy in patients after craniocerebral surgery

Objective To observe the clinical effectiveness of extracorporeal diaphragmatic pacemaker (EDP) combined with transnasal high flow oxygen therapy (HFNC) in assisting severe craniocerebral surgery. Methods A total of 50 patients who were admitted to ICU after severe craniocerebral surgery in the People's Hospital of Jinhu County from June 2019 to September 2021 were selected. After the patients were weaned from mechanical ventilation, they were randomly divided into two groups (n=25): a HFNC group and a HFNC+ EDP group. The HFNC group was given sequential treatment of HFNC, while the HFNC+EDP group was treated with EDP in addition to HFNC. Their oxygenation index (OI) immediately after and 1 h, 12 h, 24 h and 48 h after weaning, offline time and diaphragmatic excursion were recorded. Both groups were compared for their length of ICU stay and the Glasgow Comma Scale (GCS) scores after ICU discharge. Results Compared with the HFNC group, the HFNC+EDP group presented an increased OI 1 h, 12 h, 24 h and 48 h after weaning, decreased HFNC offline time and increased diaphragmatic excursion (P<0.05). The HFNC+EDP group also presented remarkably shortened length of ICU stay and increased GSC scores after ICU discharge (P<0.05). Conclusions The combined use of EDP and HFNC can increase diaphragmatic excursion, improve OI, and shorten HFNC offline time, so as to improve prognosis and accelerate the patient's early recovery.