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High‐flow nasal cannula oxygen therapy for the treatment of acute respiratory failure secondary to SARS‐CoV‐2 pneumonia out of ICU

INTRODUCTION AND OBJECTIVES: High‐flow nasal cannula oxygen therapy (HFNC) has been successfully used for the treatment of acute hypoxaemic respiratory failure (AHRF) secondary to SARS‐CoV‐2 pneumonia and being effective in reducing progression to invasive mechanical ventilation. The objective of th...

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Autores principales: Castro, Sonia, Pedrero, Sandra, Ruiz, Luis Alberto, Serrano, Leyre, Zalacain, Rafael, Pérez‐Fernández, Silvia, Iriberri, Milagros, Cabriada, Valentín
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10500315/
https://www.ncbi.nlm.nih.gov/pubmed/37537998
http://dx.doi.org/10.1111/crj.13679
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author Castro, Sonia
Pedrero, Sandra
Ruiz, Luis Alberto
Serrano, Leyre
Zalacain, Rafael
Pérez‐Fernández, Silvia
Iriberri, Milagros
Cabriada, Valentín
author_facet Castro, Sonia
Pedrero, Sandra
Ruiz, Luis Alberto
Serrano, Leyre
Zalacain, Rafael
Pérez‐Fernández, Silvia
Iriberri, Milagros
Cabriada, Valentín
author_sort Castro, Sonia
collection PubMed
description INTRODUCTION AND OBJECTIVES: High‐flow nasal cannula oxygen therapy (HFNC) has been successfully used for the treatment of acute hypoxaemic respiratory failure (AHRF) secondary to SARS‐CoV‐2 pneumonia and being effective in reducing progression to invasive mechanical ventilation. The objective of this study was to assess the usefulness of HFNC on a hospital ward for the treatment of AHRF secondary to SARS‐CoV‐2 pneumonia and its impact on the need for intensive care unit (ICU) admission and endotracheal intubation. Other objectives include identifying potential physiological parameters and/or biomarkers for predicting treatment failure and assessing the clinical course and survival. METHODS: Observational study based on data collected prospectively between March 2020 and February 2021 in a single hospital on patients diagnosed with AHRF secondary to SARS‐CoV‐2 pneumonia who received HFNC outside an ICU. RESULTS: One hundred and seventy‐one patients out of 1090 patients hospitalised for SARS‐CoV‐2 infection. HFNC was set as the ceiling of treatment in 44 cases; 12 survived (27.3%). Among the other 127 patients, intubation was performed in 25.9% of cases with a mortality of 11.8%. Higher creatinine levels (OR 1.942, 95% CI 1.04; 3.732; p = 0.036) and Comorbidity‐Age‐Lymphocyte‐LDH (CALL) score (OR 1.273, 95% CI 1.033; 1.617; p = 0.033) were associated with a higher risk of intubation. High platelet count at HFNC initiation was predictive of good treatment response (OR 0.935, 95% CI 0.884; 0.983; p = 0.012). CONCLUSIONS: HFNC outside an ICU is a treatment with high success rate in patients with AHRF secondary to SARS‐CoV‐2 pneumonia, including in patients in whom this therapy was deemed to be the ceiling of treatment.
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spelling pubmed-105003152023-09-15 High‐flow nasal cannula oxygen therapy for the treatment of acute respiratory failure secondary to SARS‐CoV‐2 pneumonia out of ICU Castro, Sonia Pedrero, Sandra Ruiz, Luis Alberto Serrano, Leyre Zalacain, Rafael Pérez‐Fernández, Silvia Iriberri, Milagros Cabriada, Valentín Clin Respir J Original Articles INTRODUCTION AND OBJECTIVES: High‐flow nasal cannula oxygen therapy (HFNC) has been successfully used for the treatment of acute hypoxaemic respiratory failure (AHRF) secondary to SARS‐CoV‐2 pneumonia and being effective in reducing progression to invasive mechanical ventilation. The objective of this study was to assess the usefulness of HFNC on a hospital ward for the treatment of AHRF secondary to SARS‐CoV‐2 pneumonia and its impact on the need for intensive care unit (ICU) admission and endotracheal intubation. Other objectives include identifying potential physiological parameters and/or biomarkers for predicting treatment failure and assessing the clinical course and survival. METHODS: Observational study based on data collected prospectively between March 2020 and February 2021 in a single hospital on patients diagnosed with AHRF secondary to SARS‐CoV‐2 pneumonia who received HFNC outside an ICU. RESULTS: One hundred and seventy‐one patients out of 1090 patients hospitalised for SARS‐CoV‐2 infection. HFNC was set as the ceiling of treatment in 44 cases; 12 survived (27.3%). Among the other 127 patients, intubation was performed in 25.9% of cases with a mortality of 11.8%. Higher creatinine levels (OR 1.942, 95% CI 1.04; 3.732; p = 0.036) and Comorbidity‐Age‐Lymphocyte‐LDH (CALL) score (OR 1.273, 95% CI 1.033; 1.617; p = 0.033) were associated with a higher risk of intubation. High platelet count at HFNC initiation was predictive of good treatment response (OR 0.935, 95% CI 0.884; 0.983; p = 0.012). CONCLUSIONS: HFNC outside an ICU is a treatment with high success rate in patients with AHRF secondary to SARS‐CoV‐2 pneumonia, including in patients in whom this therapy was deemed to be the ceiling of treatment. John Wiley and Sons Inc. 2023-08-04 /pmc/articles/PMC10500315/ /pubmed/37537998 http://dx.doi.org/10.1111/crj.13679 Text en © 2023 The Authors. The Clinical Respiratory Journal published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Castro, Sonia
Pedrero, Sandra
Ruiz, Luis Alberto
Serrano, Leyre
Zalacain, Rafael
Pérez‐Fernández, Silvia
Iriberri, Milagros
Cabriada, Valentín
High‐flow nasal cannula oxygen therapy for the treatment of acute respiratory failure secondary to SARS‐CoV‐2 pneumonia out of ICU
title High‐flow nasal cannula oxygen therapy for the treatment of acute respiratory failure secondary to SARS‐CoV‐2 pneumonia out of ICU
title_full High‐flow nasal cannula oxygen therapy for the treatment of acute respiratory failure secondary to SARS‐CoV‐2 pneumonia out of ICU
title_fullStr High‐flow nasal cannula oxygen therapy for the treatment of acute respiratory failure secondary to SARS‐CoV‐2 pneumonia out of ICU
title_full_unstemmed High‐flow nasal cannula oxygen therapy for the treatment of acute respiratory failure secondary to SARS‐CoV‐2 pneumonia out of ICU
title_short High‐flow nasal cannula oxygen therapy for the treatment of acute respiratory failure secondary to SARS‐CoV‐2 pneumonia out of ICU
title_sort high‐flow nasal cannula oxygen therapy for the treatment of acute respiratory failure secondary to sars‐cov‐2 pneumonia out of icu
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10500315/
https://www.ncbi.nlm.nih.gov/pubmed/37537998
http://dx.doi.org/10.1111/crj.13679
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