Objective:

To examine the clinical and nursing outcomes associated with prone position ventilation (PPV) combined with high-flow nasal cannula (HFNC) oxygen therapy in patients with pulmonary infection.

Approach:

• Study Design: Retrospective analysis of 200 patients with pulmonary infection admitted to two tertiary hospitals between January 2022 and January 2024.
• Patient Groups: Patients were divided into an observation group (n = 100; PPV combined with HFNC) and a control group (n = 100; conventional oxygen therapy).
• Outcome Measures: Outcomes included PaO2/FiO2 ratio, SpO2, respiratory rate, length of hospital stay, complication and ICU-admission rates, and nurse-assessed comfort and compliance.
• Statistical Analysis: Longitudinal data were analyzed using repeated-measures ANOVA and Bonferroni-corrected post-hoc comparisons, along with multivariable-adjusted and sensitivity analyses.

Key Findings:

• The observation group showed greater improvements in PaO2/FiO2 ratio and SpO2 over the first 72 hours compared to the control group.
• Nurse-assessed comfort and compliance scores were higher in the observation group.
• Total complications were lower in the observation group (9.0% vs. 45.0%).
• ICU admission rates were lower in the observation group (5.0% vs. 19.0%).
• Length of hospital stay was shorter in the observation group (8.7 ± 2.4 vs. 12.0 ± 2.9 days).

Interpretation:

PPV combined with HFNC oxygen therapy was associated with better respiratory outcomes and fewer complications compared to conventional oxygen therapy, but causality cannot be established due to non-randomized allocation.

Limitations:

• The study was non-randomized, which limits the ability to establish causality.
• Findings are based on a retrospective analysis and may not be generalizable to all patient populations.

Conclusion:

In this retrospective, non-randomized cohort, PPV combined with HFNC oxygen therapy was associated with better respiratory outcomes, fewer complications, shorter hospitalization and higher nurse-assessed comfort and compliance than conventional oxygen therapy.