tetano
Editor, Senior Moderator
Ann Intensive Care. 2020 Mar 30;10(1):37. doi: 10.1186/s13613-020-00653-z.
The experience of high-flow nasal cannula in hospitalized patients with 2019 novel coronavirus-infected pneumonia in two hospitals of Chongqing, China.
Wang K[SUP]1[/SUP], Zhao W[SUP]2[/SUP], Li J[SUP]3[/SUP], Shu W[SUP]4[/SUP], Duan J[SUP]5[/SUP].
Author information
Abstract
BACKGROUND:
The outbreak of a novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) is currently ongoing in China. Most of the critically ill patients received high-flow nasal cannula (HFNC) oxygen therapy. However, the experience of HFNC in this population is lacking.
METHODS:
We retrospectively screened 318 confirmed patients with NCIP in two hospitals of Chongqing, China, from January 1st to March 4th, 2020. Among them, 27 (8.4%) patients experienced severe acute respiratory failure including 17 patients (63%) treated with HFNC as first-line therapy, 9 patients (33%) treated with noninvasive ventilation (NIV) and one patient (4%) treated with invasive ventilation. HFNC failure was defined by the need of NIV or intubation as rescue therapy.
RESULTS:
Of the 17 HFNC patients, 7 (41%) experienced HFNC failure. The HFNC failure rate was 0% (0/6) in patients with PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] > 200 mm Hg vs. 63% (7/11) in those with PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] ≤ 200 mm Hg (p = 0.04). Compared with baseline data, the respiratory rate significantly decreased after 1-2 h of HFNC in successful group [median 26 (IQR: 25-29) vs. 23 (22-25), p = 0.03]. However, it did not in the unsuccessful group. After initiation of NIV as rescue therapy among the 7 patients with HFNC failure, PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] significantly improved after 1-2 h of NIV [median 172 (150-208) mmHg vs. 114 (IQR: 79-130) under HFNC, p = 0.04]. However, two out of seven (29%) patients with NIV as rescue therapy ultimately received intubation. Among the 27 patients with severe acute respiratory failure, four patients were eventually intubated (15%).
CONCLUSIONS:
Our study indicated that HFNC was the most common ventilation support for patients with NCIP. Patients with lower PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] were more likely to experience HFNC failure.
KEYWORDS:
Coronavirus; High-flow nasal cannula; Pneumonia
PMID:32232685PMCID:PMC7104710DOI:10.1186/s13613-020-00653-z
Free PMC Article
The experience of high-flow nasal cannula in hospitalized patients with 2019 novel coronavirus-infected pneumonia in two hospitals of Chongqing, China.
Wang K[SUP]1[/SUP], Zhao W[SUP]2[/SUP], Li J[SUP]3[/SUP], Shu W[SUP]4[/SUP], Duan J[SUP]5[/SUP].
Author information
Abstract
BACKGROUND:
The outbreak of a novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) is currently ongoing in China. Most of the critically ill patients received high-flow nasal cannula (HFNC) oxygen therapy. However, the experience of HFNC in this population is lacking.
METHODS:
We retrospectively screened 318 confirmed patients with NCIP in two hospitals of Chongqing, China, from January 1st to March 4th, 2020. Among them, 27 (8.4%) patients experienced severe acute respiratory failure including 17 patients (63%) treated with HFNC as first-line therapy, 9 patients (33%) treated with noninvasive ventilation (NIV) and one patient (4%) treated with invasive ventilation. HFNC failure was defined by the need of NIV or intubation as rescue therapy.
RESULTS:
Of the 17 HFNC patients, 7 (41%) experienced HFNC failure. The HFNC failure rate was 0% (0/6) in patients with PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] > 200 mm Hg vs. 63% (7/11) in those with PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] ≤ 200 mm Hg (p = 0.04). Compared with baseline data, the respiratory rate significantly decreased after 1-2 h of HFNC in successful group [median 26 (IQR: 25-29) vs. 23 (22-25), p = 0.03]. However, it did not in the unsuccessful group. After initiation of NIV as rescue therapy among the 7 patients with HFNC failure, PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] significantly improved after 1-2 h of NIV [median 172 (150-208) mmHg vs. 114 (IQR: 79-130) under HFNC, p = 0.04]. However, two out of seven (29%) patients with NIV as rescue therapy ultimately received intubation. Among the 27 patients with severe acute respiratory failure, four patients were eventually intubated (15%).
CONCLUSIONS:
Our study indicated that HFNC was the most common ventilation support for patients with NCIP. Patients with lower PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] were more likely to experience HFNC failure.
KEYWORDS:
Coronavirus; High-flow nasal cannula; Pneumonia
PMID:32232685PMCID:PMC7104710DOI:10.1186/s13613-020-00653-z
Free PMC Article