학술논문
A Prospective Observational Study on Short and Long-Term Outcomes of COVID-19 Patients with Acute Hypoxic Respiratory Failure Treated with High-Flow Nasal Cannula
Document Type
Clinical report
Author
Medeiros, Kyle J.; Valsecchi, Carlo; Winterton, Dario; Morais, Caio A.; Delgado, Eduardo Diaz; Smith, Shaun; Safaee Fakhr, Bijan; Ranjeva, Sylvia; Capriles, Martin; Gaulton, Timothy; Li, Matthew D.; Fintelmann, Florian; Tahir, Ismail; Carroll, Ryan; Bittner, Edward A.; Hibbert, Kathryn A.; Thompson, Boyd Taylor; Hardin, Charles C.; Santiago, Roberta RS; La Vita, Carolyn J.; Cereda, Maurizio; Berra, Lorenzo
Source
Journal of Clinical Medicine. February 2023, Vol. 12 Issue 4
Subject
Language
English
ISSN
2077-0383
Abstract
Author(s): Kyle J. Medeiros [1]; Carlo Valsecchi [1,2]; Dario Winterton [1,2]; Caio A. Morais [1,2]; Eduardo Diaz Delgado [1]; Shaun Smith [3]; Bijan Safaee Fakhr [1,2]; Sylvia Ranjeva [1,2]; Martin [...]
(1) The use of high-flow nasal cannula (HFNC) combined with frequent respiratory monitoring in patients with acute hypoxic respiratory failure due to COVID-19 has been shown to reduce intubation and mechanical ventilation. (2) This prospective, single-center, observational study included consecutive adult patients with COVID-19 pneumonia treated with a high-flow nasal cannula. Hemodynamic parameters, respiratory rate, inspiratory fraction of oxygen (F[sub.i]O[sub.2]), saturation of oxygen (S[sub.p]O[sub.2]), and the ratio of oxygen saturation to respiratory rate (ROX) were recorded prior to treatment initiation and every 2 h for 24 h. A 6-month follow-up questionnaire was also conducted. (3) Over the study period, 153 of 187 patients were eligible for HFNC. Of these patients, 80% required intubation and 37% of the intubated patients died in hospital. Male sex (OR = 4.65; 95% CI [1.28; 20.6], p = 0.03) and higher BMI (OR = 2.63; 95% CI [1.14; 6.76], p = 0.03) were associated with an increased risk for new limitations at 6-months after hospital discharge. (4) 20% of patients who received HFNC did not require intubation and were discharged alive from the hospital. Male sex and higher BMI were associated with poor long-term functional outcomes.
(1) The use of high-flow nasal cannula (HFNC) combined with frequent respiratory monitoring in patients with acute hypoxic respiratory failure due to COVID-19 has been shown to reduce intubation and mechanical ventilation. (2) This prospective, single-center, observational study included consecutive adult patients with COVID-19 pneumonia treated with a high-flow nasal cannula. Hemodynamic parameters, respiratory rate, inspiratory fraction of oxygen (F[sub.i]O[sub.2]), saturation of oxygen (S[sub.p]O[sub.2]), and the ratio of oxygen saturation to respiratory rate (ROX) were recorded prior to treatment initiation and every 2 h for 24 h. A 6-month follow-up questionnaire was also conducted. (3) Over the study period, 153 of 187 patients were eligible for HFNC. Of these patients, 80% required intubation and 37% of the intubated patients died in hospital. Male sex (OR = 4.65; 95% CI [1.28; 20.6], p = 0.03) and higher BMI (OR = 2.63; 95% CI [1.14; 6.76], p = 0.03) were associated with an increased risk for new limitations at 6-months after hospital discharge. (4) 20% of patients who received HFNC did not require intubation and were discharged alive from the hospital. Male sex and higher BMI were associated with poor long-term functional outcomes.