학술논문
High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure
Document Type
Report
Author
Mellado-Artigas, Ricard; Ferreyro, Bruno L.; Angriman, Federico; Hernández-Sanz, María; Arruti, Egoitz; Torres, Antoni; Villar, Jesús; Brochard, Laurent; Ferrando, Carlos; Vendrell, Marina; Sánchez-Etayo, Gerard; Alcón, Amalia; Belda, Isabel; Agustí, Mercé; Carramiéana, Albert; Gracia, Isabel; Panzeri, Miriam; León, Irene; Balust, Jaume; Navarro, Ricard; Arguís, María José; Carretero, María José; Ibáéez, Cristina; Perdomo, Juan; López, Antonio; López-Baamonde, Manuel; Cuéat, Tomás; Ubré, Marta; Ojeda, Antonio; Calvo, Andrea; Rivas, Eva; Hurtado, Paola; Pujol, Roger; Martín, Nuria; Tercero, Javier; Sanahuja, Pepe; Magaldi, Marta; Coca, Miquel; del Rio, Elena; Martínez-Ocon, Julia; Masgoret, Paula; Tio, Monserrat; Caballero, Angel; Risco, Raquel; Bergé, Raquel; Gómez, Lidia; de Riva, Nicolás; Ruiz, Ana; Tena, Beatriz; Jaramillo, Sebastián; Balibrea, José María; de Lacy, Francisco Borja de Borja; Otero, Ana; Ibarzabal, Ainitze; Bravo, Raquel; Carreras, Anna; Martín-Barreda, Daniel; Alias, Alfonso Jesús; Balaguer, Mariano; Aliaga, Jorge; Almuedo, Alex; Alonso, Joan Ramón; Andrea, Rut; Angelès, Gerard Sergi; Arias, Marilyn; Aziz, Fátima; Badía, Joan Ramon; Barbeta, Enric; Torres, Toni; Batiste, Guillem; Benet, Pau; Borrat, Xavi; Borrell, María; Bragulat, Ernest; Carmona, Inmaculada; Castellà, Manuel; Castro, Pedro; Ceravalls, Joan; Comino, Oscar; Cucciniello, Claudia; De Deray, Clàudia; De Diego, Oriol; De la Matta, Paula; Farrero, Marta; Fernández, Javier; Fernández, Sara; Fernández, Anna; Ferrer, Miquel; Fervienza, Ana; Tallo Forga, María; Forné, Daniel; Galán, Clàudia; Gómez, Andrea; Guasch, Eduard; Hernández-Tejero, María; Jacas, Adriana; Jiménez, Beltrán; Leyes, Pere; López, Teresa; Martínez, José Antonio; Martínez-Pallí, Graciela; Mercadal, Jordi; Muéoz, Guido; Muéoz, José; Nicolás, Josep María; Ortiz, José Tomás; Peiró, Anna; Pérez, Manuel; Poch, Esteban; Pujol, Margarida; Quintana, Eduard; Ramis, Bartomeu; Reverter, Enric; Rovira, Irene; Ruiz, Pablo; Sandoval, Elena; Schneider, Stefan; Sibila, Oriol; Solé, Carla; Soriano, Alex; Soy, Dolors; Suárez, M.; Téllez, Adrián; Toapanta, Néstor David; Urra, Xavier; Aldecoa, César; Bordell, Alicia; Martín, Silvia; Andrés, Judith; Ruiz, Alberto Martínez; Medel, Gonzalo Tamayo; Villasante, Iéaki Bilbao Bilbao; Clavero, Fernando Iturri; Ãlvarez, Covadonga Peralta; Herrera Díez, Julia T.; Trancho, Andrea García; Mandiola, Iéaki Sainz; Suarez, Carmen Ruano; Bocos, Angela Ruiz; Izagirre, Eneritz Urrutia; de Urbina Fernández, Pablo Ortiz; López, Naiara Apodaka; Molano, Leire Prieto; Martínez, Eunate Ganuza; Hidalgo, Iratxe Vallinas; de Orte Sancho, Karmele; Paniagua, Celia González; Labrador, Gemma Ortiz; Larraéaga, Mireia Pérez; Miguelez, Marta López; Andrés, Estíbaliz Bárcena; Laureano, Erik Urutxurtu; Boedo, Maria Jesús Maroéo; Rodríguez, Blanca Escontrela; Camiruaga, Aitziber Ereéozaga; Aguirre, Deiene Lasuen; Maeztu, Ainhoa Zabal; Gala, Ane Guereca; Korro, Iker Castelo; Campo, Andrés Ãlvarez; Viana, Alejandro Carcelen; Enríquez, Alejandro Alberdi; Rementeria, Xabier Ormazábal; Campos, Alberto Sánchez; Rico, Rosa Gutiérrez; Damborenea, Pablo Barbier; Momeée, Marta Guerenabarrena; Ruiz, Borja Cuesta; Rico, Alejandro López; Polo, Ana Rojo; Grijelmo, Covadonga García; Reta, Mikel Celorrio; Arroyo, Eneko Martín; Aparicio, Leire Artaza; Aspiazu, Iéaki Ituarte; Basabe, Ane Igeregi; Julian, Itxaso Merino; Rico, Isabel Diaz; Martínez, Maria Paz; Adalia Bartolomé, Ramón; Zattera, Luigi; Hernandez, Irina Adalid; Altuna, Leire Larraéaga; Castells, Aina Serrallonga; Garcia, Adriana Vílchez; Núéez, María; Román, Lorena; Delgado, Isabel Ramos; Martínez, Adela Benítez-Cano; Albert, Mireia Chanzá; García, Juan Carlos Ãlvarez; Cuchillo, Luis Aguilera; de Heredia, Sandra Beltrán; Cordobés, Jesús Carazo; Bernedo, Carlos Alberto García; Villén, Fernando Escolano; Calvo, Francisco Javier Redondo; González, Rubén Villazala; González, Victor Baladron; Faba, Patricia; Montenegro, Omar; Ramírez, Natalia Bejarano; Contreras, Sergio Marcos; Rodríguez, Alejandro Garcia; Vázquez, Saleta Rey; Pérez, Cristina Garcia; Miguelez, Eva Higuera; Blanco, Irene Pérez; Rivera, David García; de la Fuente, Ane Martín; Pardo, Marta; Rodriguez, Vanessa; Bengoetxea, Unai; Ramasco, Fernando; Bernal, Sheila Olga Santidrián; Hernando, Alvar Santa Cruz; Roca, Antonio Planas; Yusta, Carlos Figueroa; Villabona, Esther García; Lantero, Carmen Vallejo; Rodriguez, Eva Patiéo; Toledo, Alvaro Esquivel; Méndez, David Arribas; Rodriguez, Mar Orts; Hernández, Rosa Méndez; Alonso, Jesús Nieves; Artazcoz, Inés Imaz; Carazo, Sonia Expósito; Guerrero, Carlos Román; Rodríguez, Elena Rojo; González, Ricardo Moreno; Santos, Julia Hernando; Pérez, Jara Torrente; Mena, Esperanza Mata; Martínez, Manuel José Muéoz; Muéoz, Enrique Alday; Serrano, Patricia Martin; Muéoz, Laura Cotter; Mjertan, Amadea; Martínez, Diego Gutierrez; García, Carmen Rodríguez; Viejo, Olaya Alonso; Pereira, Juan Alvarez; Bonet, Ana Carmona; López, Diana Parrado; de Dios Tomas, Eva; Celemin, Rafael Martín; Paz, María Luisa Meilan; Gutiérrez, Luis Quecedo; Velasco, Noemí Diaz; Hernández, Gabriel Martin; del Corral, Francisco Garcia; Arias, Gloria Hernandez; Cuesta, David Rodriguez; Rice, Ana Gómez; Sevillano, Encarna Mateos; Molpeceres, Natalia Olmos; Domínguez, Beatriz; Lima, Ana Vázquez; Candela, Ãngel; Bambaren, Ismael A. Acevedo; Blanco, Maria Isabel Albala; Montoiro, Paloma Alonso; Utrera, Fernando Ãlvarez; Esteruelas, Juan Avellanosa; López, Amal Azzam; Balvis, Alberto José; Bardi, Balvis Tommaso; Martín, María Beltrán; Haserfaty, Jacobo Benatar; Camacho, Alberto Berruezo; Weimer, Laura Betolaza; del Mar Carbonell Soto, María; Seral, Cristina Carrasco; Zaballos, Cristina Cerro; Llamas, Elizabeth Claros; Orduna, Pilar Coleta; Forero, Ingrid P. Cortes; Aliseda, Pascual Agustín Crespo; de Pablo Pajares, María Angélica; Remesal, Yolanda Díez; Díaz, Trinidad Dorado; Blasco, Noemí Echevarría; Martín, María Elena Elías; Triviéo, Javier Felices; López, Natalia Fernández; Martín, Cristina Fernández; Pozuelo, Natalia Ferreiro; Martín, Luis Gajate; Santos, Clara Gallego; Mayo, Diego Gil; Rojo, María Gómez; Cibrián, Claudia González; López, Elena Herrera; Olmedillo, Borja Hinojal; Gallego, Berta Iglesias; Khonsari, Sassan; Ruiz, María Nuria Mane; Arroyo, María Manzanero; Ortega, Ana María Mariscal; Burcio, Sara Martín; del Carmen Martín González, María; Grande, Ascensión Martín; López, Jose Juan Martín; Rabes, Cecilia Martín; Borja, Marcos Martínez; Castro, Nilda Martínez; Pérez, Adolfo Martínez; Matcan, Snejana; Viéas, Cristina Medrano; Herrera, Lisset Miguel; Betancur, Adrián Mira; Carbajo, María Montiel; Moradas, Javier Moya; Pérez, Lorena Muéoz; Murias, Mónica Nuéez; González, Eva Ordiales; Recio, Ãscar Ordoéez; Rodriguez, Miguel Ãngel Palomero; Roux, Diego Parise; Torres, Lucia Pereira; Lagunas, David Pestaéa; Corraliza, Juana María Pinto; Rodrigo, Marian Prieto; Diaz-Regaéo, Inmaculada Rodriguez; Esteban, David Rodriguez; Pernia, Víctor Rojas; Saiz, Ãlvaro Ruigómez; Villarino, Bárbara Saavedra; Palero, Noemí Samaranch; Pérez, Gloria Santos; Pérez, Jaume Serna; Romero, Ana Belén Serrano; López, Jesús Tercero; García, Carlos Tiscar; de la Torre Concostrina, Marta; Mesa, Eva María Ureta; Olarte, Eva Velasco; Martínez, Judith Villahoz; Palacios, Raúl Villalaba; García, Gema Villanueva; de Medeiros, Cristina Vogel; Ovejero, Soraya Gholamian; Orgaz, Marta Vicente; Herradon, Patricia Lloreda; Gómez, Cristina Crespo; Sarmiento-Trujillo, Tatiana; Medina, Noemí García; García, María Martínez; Ramírez, Carles Espinós; Rivero, Nabil Mouhaffel; Gil, Jose Antonio Bernia; Martín, Sonsoles; Moral, María Victoria; Galán, Josefina; Paniagua, Pilar; Pérez, Sergio; Bainac, Albert; Arias, Ana; Ramil, Elsa; Escudero, Jorge; Monedero, Pablo; Cara, Carmen; Lara, Andrea; Martínez, Elena Mendez; Mendoza, Jorge; Baines, Ãéigo Rubio; Trull, Carmen Sala; López, Pablo Montero; Gea, Alfredo; Montero, Alejandro; Ibaéez, Rocío Armero; Pitarch, Juan Vicente Llau; Alcóver, Fernando Rauer; Herreros, Cristina Ãlvarez; Martín, Cyntia Sánchez; Olmos, Lucía López Ocáriz; Moruno, Marta Navas; Montoto, Fernando García; Rodriguez, M. F. Mirón; Coco, Laura Fuentes; Gamito, Cristina Hernández; Orejudo, Antonio Barba; Vielma, Luis Gerardo Smith; de Borja Amador Penco, Yasmina González Marín Francisco; Domínguez, Marta Donoso; Ramírez, Silvia Esquivel; Carbonell, José Antonio; López, Berta Monleón; Martínez-Castro, Sara; Aguilar, Gerardo; Casas, María Gestal Pablo; Rosato, Angel Outeiro; Pan, Andrea Naveiro; Portela, María Alonso; Romar, Adrián García; Rodríguez, Eva Mosquera; Seijo, Diego Ruanova; Maceiras, Pablo Rama; Castro-Ceoane, Francisco; López, Esther Moreno; Gil, Sergio; Antón, Julia Guillén; Tirado, Patricia García-Consuegra; Calvo, Aurora Callau; Lisbona, Laura Forés; Romero, María Carbonell; Gil, Belén Albericio; Jarne, Laura Pradal; Lozano, María Soria; López, Diego Loscos; Díez-Domínguez, Andrea Patiéo Abarca, Jordi Serrano, Javier Pérez-Asenjo Ãngel; Zubizarreta, Ion; Ramos, Jon; de la Rica, Iosu Fernández, Emilio Maseda Alejandro Suárez; Sagra, Javier Veganzones, Itziar Insausti Javier; Carrasco, Sofía Díaz; Feijoo, Ana Montero; Hortal, Julio Yagüe, Ignacio Garutti Javier; Piéeiro, Patricia; Piéeiro, Matilde; Zaballos, Matilde; cedeéo, Jamil; García-Olivares, Pablo; Garriido, Alberto; Guerrero, Jose Eugenioi; Rosa, Eva Bassas Parga, Carmen Deiros Garcia Elisenda Pujol; Navarro, Ana Tejedor; Gabernet, Roser Font; Bernat, Maria José; Valls, Meritxell Serra; Garcia-Bernalt, Cristina Cobaleda; Anton, Jesus Fernanz; Sierra, Adriana Aponte; Gomez, Lucia Gil; Vaqueiro, Olaia Guenaga; Marin, Susana Hernandez; Orejuela, Laura Pardo Pinzon, Sira Garcia Aranda Carlos Briones; Sánchez, Edgar Cortes; Fernández, Alejandro Romero; SanJosé, Esther Fernández; Garsabal, Patricia Iglesias; Lopez, Guillermo Isidro; Vicol, Ana; Malagon, Sara Espejo; Alcaide, María Sanabra Loewe, Laura Grau Torradeflo Lourdes Blanco; Mendoza, Gloria Buenaventura Sanclemente, Pere Serra Pujol Gustavo Cuadros; Golska, Miroslawa Konarska, Fedra Bachs Almenara Agnieszka; Carmona Blesa, Aleix; Serra, Arantxa Mas; Melchor, Javier Ripolles; Moreno, Ana Nieto; Novo, Káteri Chao; López, Sandra Gadín; Moreno, Elena Nieto; Tonal, Bérénice Gutiérrez; de Pablo, Elena Lucena; Yaéez, Barbara Algar; Rivero, Beatriz Vázquez; Mateo, Beatriz Nozal; de Retes, Marina; Escoda, Norma Aracil; Mayo, Cristina Gallardo; González, Rosa Sanz; Peéa, Alicia Ruiz Escobar, Maria Laura Pelegrina López Marina Valenzuela; Dueéas, David Stolle; Motos, Ane Abad; Abad-Gurumeta, Alfredo; Errazquin, Ana Tirado; Ruiz, Elena Sáez; Pérez, Nerea Gómez; de Borja Bau González, Cesar Morcillo Serra Jessica Souto Higueras, Rosario Vicente Raquel Ferrandis, Francisco; Martín, Silvia Polo; Moncho, Azucena Pajares; Puigdollers, Ignacio Moreno; Cortés, Juan Pérez Artacho; Calvo, Ana Moret; Peéa, Ana Pi; Parada, María Catalán Fernández, Marina Varela Pilar Díaz; Carlín, Raquel Rey; Aragunde, Sarra Barreiro; Chiva, María Isabel Forés; Agulló, A. Javier; Ferrer, Antonio Pérez; Galiana, María; del Rio, Antoni Margarit Válerie Mourre; Muxella, Eva Heras; Vidal, Anna
Source
Critical Care. February 11, 2021, Vol. 25 Issue 1
Subject
Language
English
ISSN
1364-8535
Abstract
Author(s): Ricard Mellado-Artigas[sup.1] , Bruno L. Ferreyro[sup.2,3] , Federico Angriman[sup.3,4] , María Hernández-Sanz[sup.5] , Egoitz Arruti[sup.6] , Antoni Torres[sup.7,8,9] , Jesús Villar[sup.8,10,11] , Laurent Brochard[sup.3,11] , Carlos Ferrando[sup.1,8] , Ricard [...]
Purpose Whether the use of high-flow nasal oxygen in adult patients with COVID-19 associated acute respiratory failure improves clinically relevant outcomes remains unclear. We thus sought to assess the effect of high-flow nasal oxygen on ventilator-free days, compared to early initiation of invasive mechanical ventilation, on adult patients with COVID-19. Methods We conducted a multicentre cohort study using a prospectively collected database of patients with COVID-19 associated acute respiratory failure admitted to 36 Spanish and Andorran intensive care units (ICUs). Main exposure was the use of high-flow nasal oxygen (conservative group), while early invasive mechanical ventilation (within the first day of ICU admission; early intubation group) served as the comparator. The primary outcome was ventilator-free days at 28 days. ICU length of stay and all-cause in-hospital mortality served as secondary outcomes. We used propensity score matching to adjust for measured confounding. Results Out of 468 eligible patients, a total of 122 matched patients were included in the present analysis (61 for each group). When compared to early intubation, the use of high-flow nasal oxygen was associated with an increase in ventilator-free days (mean difference: 8.0 days; 95% confidence interval (CI): 4.4 to 11.7 days) and a reduction in ICU length of stay (mean difference: - 8.2 days; 95% CI - 12.7 to - 3.6 days). No difference was observed in all-cause in-hospital mortality between groups (odds ratio: 0.64; 95% CI: 0.25 to 1.64). Conclusions The use of high-flow nasal oxygen upon ICU admission in adult patients with COVID-19 related acute hypoxemic respiratory failure may lead to an increase in ventilator-free days and a reduction in ICU length of stay, when compared to early initiation of invasive mechanical ventilation. Future studies should confirm our findings. Keywords: COVID-19, Acute hypoxemic respiratory failure, High-flow nasal oxygen, Ventilator-free days
Purpose Whether the use of high-flow nasal oxygen in adult patients with COVID-19 associated acute respiratory failure improves clinically relevant outcomes remains unclear. We thus sought to assess the effect of high-flow nasal oxygen on ventilator-free days, compared to early initiation of invasive mechanical ventilation, on adult patients with COVID-19. Methods We conducted a multicentre cohort study using a prospectively collected database of patients with COVID-19 associated acute respiratory failure admitted to 36 Spanish and Andorran intensive care units (ICUs). Main exposure was the use of high-flow nasal oxygen (conservative group), while early invasive mechanical ventilation (within the first day of ICU admission; early intubation group) served as the comparator. The primary outcome was ventilator-free days at 28 days. ICU length of stay and all-cause in-hospital mortality served as secondary outcomes. We used propensity score matching to adjust for measured confounding. Results Out of 468 eligible patients, a total of 122 matched patients were included in the present analysis (61 for each group). When compared to early intubation, the use of high-flow nasal oxygen was associated with an increase in ventilator-free days (mean difference: 8.0 days; 95% confidence interval (CI): 4.4 to 11.7 days) and a reduction in ICU length of stay (mean difference: - 8.2 days; 95% CI - 12.7 to - 3.6 days). No difference was observed in all-cause in-hospital mortality between groups (odds ratio: 0.64; 95% CI: 0.25 to 1.64). Conclusions The use of high-flow nasal oxygen upon ICU admission in adult patients with COVID-19 related acute hypoxemic respiratory failure may lead to an increase in ventilator-free days and a reduction in ICU length of stay, when compared to early initiation of invasive mechanical ventilation. Future studies should confirm our findings. Keywords: COVID-19, Acute hypoxemic respiratory failure, High-flow nasal oxygen, Ventilator-free days