High-flow nasal cannula oxygen therapy in hypoxemic patients with COVID-19: A retrospective observational study

Abstract

Objective: To describe high-flow nasal cannula (HFNC) ventilatory a sistance in patients with hypoxemic acute respiratory failure due to COVID-19. Methods: This is a retrospective study of patients admitted to a single center from May 2020 to December 2021 with hypoxemic acute respiratory failure due to COVID-19 treated with HFNC. Age, gender, APACHE II score, initial HFNC flow, inspired oxygen fraction measurements, ROX index at 2, 6, and 12 hours after its institution, treatment duration, and its outcomes (success or failure rate) were observed, in addition to the length of stay, discharge, and mortality in the intensive care unit (ICU). Results: 190 patients were included, with therapy success of 51.05% (97 individuals) (p<0.05). The success group is younger (p<0.0001), APACHE II and expected mortality lower (p<0.002; p<0.005), used HFNC for a longer time (p<0.0001), with lower flow and FiO2 (p<0.002; p<0.0005) and higher ROX index in all measured periods, remained in the ICU for a shorter period (p<0.0001) and all individuals were discharged from the ICU. Significant predictive variables of the primary outcome (success or failure) were the APACHE II score, expected mortality, 12-hour ROX index, days of use in the HFNC, discharge from the ICU, and days of stay in the ICU (p<0.0001). Conclusion: HFNC was an effective treatment in non-invasive ventilatory support in patients with hypoxemic acute respiratory failure due to COVID-19.

Keywords

• high-flow nasal cannula
• covid-19
• sars-cov-2
• acute hypoxemic respiratory failure