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High-flow nasal cannula oxygen therapy in hypoxic patients with COVID-19 pneumonia: A retrospective cohort study confirming the utility of respiratory rate index

BACKGROUND: Although high-flow nasal cannula (HFNC) oxygen treatment has been frequently used in coronavirus disease 2019 (COVID-19) patients with acute respiratory failure after the 3rd wave of the pandemic in Japan, the usefulness of the indicators of ventilator avoidance, including respiratory ra...

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Autores principales: Takeshita, Yuichiro, Terada, Jiro, Hirasawa, Yasutaka, Kinoshita, Taku, Tajima, Hiroshi, Koshikawa, Ken, Kinouchi, Toru, Isaka, Yuri, Shionoya, Yu, Tada, Yuji, Tsushima, Kenji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Respiratory Society. Published by Elsevier B.V. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556581/
https://www.ncbi.nlm.nih.gov/pubmed/34772644
http://dx.doi.org/10.1016/j.resinv.2021.10.005
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author Takeshita, Yuichiro
Terada, Jiro
Hirasawa, Yasutaka
Kinoshita, Taku
Tajima, Hiroshi
Koshikawa, Ken
Kinouchi, Toru
Isaka, Yuri
Shionoya, Yu
Tada, Yuji
Tsushima, Kenji
author_facet Takeshita, Yuichiro
Terada, Jiro
Hirasawa, Yasutaka
Kinoshita, Taku
Tajima, Hiroshi
Koshikawa, Ken
Kinouchi, Toru
Isaka, Yuri
Shionoya, Yu
Tada, Yuji
Tsushima, Kenji
author_sort Takeshita, Yuichiro
collection PubMed
description BACKGROUND: Although high-flow nasal cannula (HFNC) oxygen treatment has been frequently used in coronavirus disease 2019 (COVID-19) patients with acute respiratory failure after the 3rd wave of the pandemic in Japan, the usefulness of the indicators of ventilator avoidance, including respiratory rate-oxygenation (ROX) index and other parameters, namely oxygen saturation/fraction of inspired oxygen ratio and respiratory rate (RR), remain unclear. METHODS: Between January and May 2021, our institution treated 189 COVID-19 patients with respiratory failure requiring oxygen, among which 39 patients requiring HFNC treatment were retrospectively analyzed. The group that switched from HFNC treatment to conventional oxygen therapy (COT) was defined as the HFNC success group, and the group that switched from HFNC treatment to a ventilator was defined as the HFNC failure group. We followed the patients’ oxygenation parameters for a maximum of 30 days. RESULTS: HFNC treatment success occurred in 24 of 39 patients (62%) treated with HFNC therapy. Compared with the HFNC failure group, the HFNC success group had a significantly higher degree of RR improvement in the univariate analysis. Logistic regression analysis of HFNC treatment success adjusting for age, respiratory improvement, and a ROX index ≥5.55 demonstrated that an improved RR was associated with HFNC treatment success. The total COT duration was significantly shorter in the HFNC success group than in the HFNC failure group. CONCLUSIONS: HFNC treatment can be useful for ventilator avoidance and allow the quick withdrawal of oxygen administration. RR improvement may be a convenient, useful, and simple indicator of HFNC treatment success.
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spelling pubmed-85565812021-11-01 High-flow nasal cannula oxygen therapy in hypoxic patients with COVID-19 pneumonia: A retrospective cohort study confirming the utility of respiratory rate index Takeshita, Yuichiro Terada, Jiro Hirasawa, Yasutaka Kinoshita, Taku Tajima, Hiroshi Koshikawa, Ken Kinouchi, Toru Isaka, Yuri Shionoya, Yu Tada, Yuji Tsushima, Kenji Respir Investig Original Article BACKGROUND: Although high-flow nasal cannula (HFNC) oxygen treatment has been frequently used in coronavirus disease 2019 (COVID-19) patients with acute respiratory failure after the 3rd wave of the pandemic in Japan, the usefulness of the indicators of ventilator avoidance, including respiratory rate-oxygenation (ROX) index and other parameters, namely oxygen saturation/fraction of inspired oxygen ratio and respiratory rate (RR), remain unclear. METHODS: Between January and May 2021, our institution treated 189 COVID-19 patients with respiratory failure requiring oxygen, among which 39 patients requiring HFNC treatment were retrospectively analyzed. The group that switched from HFNC treatment to conventional oxygen therapy (COT) was defined as the HFNC success group, and the group that switched from HFNC treatment to a ventilator was defined as the HFNC failure group. We followed the patients’ oxygenation parameters for a maximum of 30 days. RESULTS: HFNC treatment success occurred in 24 of 39 patients (62%) treated with HFNC therapy. Compared with the HFNC failure group, the HFNC success group had a significantly higher degree of RR improvement in the univariate analysis. Logistic regression analysis of HFNC treatment success adjusting for age, respiratory improvement, and a ROX index ≥5.55 demonstrated that an improved RR was associated with HFNC treatment success. The total COT duration was significantly shorter in the HFNC success group than in the HFNC failure group. CONCLUSIONS: HFNC treatment can be useful for ventilator avoidance and allow the quick withdrawal of oxygen administration. RR improvement may be a convenient, useful, and simple indicator of HFNC treatment success. The Japanese Respiratory Society. Published by Elsevier B.V. 2022-01 2021-10-30 /pmc/articles/PMC8556581/ /pubmed/34772644 http://dx.doi.org/10.1016/j.resinv.2021.10.005 Text en © 2021 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Article
Takeshita, Yuichiro
Terada, Jiro
Hirasawa, Yasutaka
Kinoshita, Taku
Tajima, Hiroshi
Koshikawa, Ken
Kinouchi, Toru
Isaka, Yuri
Shionoya, Yu
Tada, Yuji
Tsushima, Kenji
High-flow nasal cannula oxygen therapy in hypoxic patients with COVID-19 pneumonia: A retrospective cohort study confirming the utility of respiratory rate index
title High-flow nasal cannula oxygen therapy in hypoxic patients with COVID-19 pneumonia: A retrospective cohort study confirming the utility of respiratory rate index
title_full High-flow nasal cannula oxygen therapy in hypoxic patients with COVID-19 pneumonia: A retrospective cohort study confirming the utility of respiratory rate index
title_fullStr High-flow nasal cannula oxygen therapy in hypoxic patients with COVID-19 pneumonia: A retrospective cohort study confirming the utility of respiratory rate index
title_full_unstemmed High-flow nasal cannula oxygen therapy in hypoxic patients with COVID-19 pneumonia: A retrospective cohort study confirming the utility of respiratory rate index
title_short High-flow nasal cannula oxygen therapy in hypoxic patients with COVID-19 pneumonia: A retrospective cohort study confirming the utility of respiratory rate index
title_sort high-flow nasal cannula oxygen therapy in hypoxic patients with covid-19 pneumonia: a retrospective cohort study confirming the utility of respiratory rate index
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556581/
https://www.ncbi.nlm.nih.gov/pubmed/34772644
http://dx.doi.org/10.1016/j.resinv.2021.10.005
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