{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T18:12:06Z","timestamp":1778004726775,"version":"3.51.4"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Esophageal cancer surgery frequently leads to post-extubation atelectasis. The efficacy of high-flow nasal cannula (HFNC) oxygen therapy in the post-anesthesia care unit (PACU) for these patients remains unvalidated.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This randomized controlled trial enrolled 100 patients after esophageal cancer surgery, allocated to a control group (conventional oxygen therapy at 5 L\/min, n\u2009=\u200950) or an HFNC group (heated and humidified oxygen at 40% FiO\u2082, 37\u00b0C, 10 L\/min, n\u2009=\u200950). The primary outcome was the lung ultrasound score at pre-extubation (T1), 30 minutes post-intervention (T2), and before PACU discharge (T3). The secondary outcome measures included PaO\n 2<\/jats:sub>\n \/FiO\n 2<\/jats:sub>\n , hypoxemia, incidence of pulmonary complications within 7 days post-intervention.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The reduction in lung ultrasound score from T1 to T3 was significantly greater in the HFNC group (mean change: \u22125.6 points) than in the control group (mean change: \u22121.4 points), with a between-group difference of \u22124.2 points (95% CI: \u22124.7 to \u22123.7;\n P<\/jats:italic>\n \u2009<\u20090.001). At T2 and T3, lung ultrasound score were significantly lower in the HFNC group (T2: 8.7\u2009\u00b1\u20091.2 vs. 12.7\u2009\u00b1\u20091.5; T3: 7.6\u2009\u00b1\u20091.0 vs. 11.7\u2009\u00b1\u20091.1; both\n P<\/jats:italic>\n \u2009<\u20090.001). The HFNC group also had significantly higher PaO\u2082\/FiO\u2082 ratios at T2 (325\u2009\u00b1\u200938 vs. 295\u2009\u00b1\u200935 mmHg) and T3 (340\u2009\u00b1\u200932 vs. 305\u2009\u00b1\u200930 mmHg) (both\n P<\/jats:italic>\n \u2009<\u20090.001), and a lower incidence of hypoxic events (12.0% vs. 28.0%,\n P<\/jats:italic>\n \u2009=\u20090.046) and 7-day postoperative pulmonary complications (10.0% vs. 36.0%,\n P<\/jats:italic>\n \u2009=\u20090.002). No significant differences were found in sedation scores or hemodynamic parameters.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The utilization of HFNC oxygen therapy in the PACU may provide a safe and effective means of mitigating the severity of atelectasis subsequent to extubation, enhancing oxygenation levels, and decreasing the incidence of early pulmonary complications in patients who have undergone surgical interventions for esophageal cancer.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0348511","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T17:27:15Z","timestamp":1778002035000},"page":"e0348511","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["High-flow nasal cannula oxygen therapy in post-anesthesia care unit (PACU) reduces postextubation atelectasis in patients undergoing esophageal cancer surgery: A randomized controlled trial"],"prefix":"10.1371","volume":"21","author":[{"given":"Liye","family":"Han","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Die","family":"Ren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengqi","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lili","family":"Pan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9874-9380","authenticated-orcid":true,"given":"Yun","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"pone.0348511.ref001","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2023-074962","article-title":"Advances in diagnosis and management of cancer of the esophagus","volume":"385","author":"N Deboever","year":"2024","journal-title":"BMJ"},{"issue":"4","key":"pone.0348511.ref002","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1007\/s13304-022-01269-7","article-title":"Two-lung ventilation or one-lung ventilation for esophagectomy: maybe the more is better from the evidence of meta-analysis","volume":"74","author":"H-Y Deng","year":"2022","journal-title":"Updates Surg"},{"issue":"3","key":"pone.0348511.ref003","doi-asserted-by":"crossref","first-page":"2530","DOI":"10.21037\/apm-20-1539","article-title":"A postoperative comparison of high-flow nasal cannula therapy and conventional oxygen therapy for esophageal cancer patients","volume":"10","author":"M Xia","year":"2021","journal-title":"Ann Palliat Med"},{"key":"pone.0348511.ref004","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1097\/ALN.0000000000004009","article-title":"Perioperative pulmonary atelectasis: part II. 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