The Evaluation of COVID-19 Patients Treated with HFNC in Intensive Care Unit

Abstract

Objective: Since the coronavirus disease-2019 (COVID-19) pandemic caused respiratory failure in many patients, oxygen delivery methods had to be diversified, and their numbers increased. High flow nasal cannula (HFNC), which has been shown beneficial in acute respiratory failure previously, also came to the fore. We investigated the efficacy of HFNC on patients hospitalized in intensive care units due to COVID-19. Materials and Methods: We retrospectively screened the patients followed up in the intensive care unit due to COVID-19. Patients treated with HFNC performed the study group. We analyzed the relationships among demographics, laboratory results, treatment modalities, complications, and outcomes. Results: Among the 330 patients including mean ventilation duration with HFNC was 7.84 days. One hundred seventy (51.5%) patients were intubated during HFNC treatment. Only 5 of them were extubated. Intubated patients had higher mean HFNC duration [9.74 days - minimum (min): 2 , maximum (max): 49] compared to non-intubated patients (6.05 days - min: 1, max: 30). There was a significant relationship between mortality and age [Odds ratio (OR): 1.04], Acute Physiology and Chronic Health Evaluation-II score (OR: 1.35), having cancer (OR: 3.89), receiving non-invasive ventilation (OR: 5.94), and presence of secondary bacterial infection (OR: 44.6). Conclusion: HFNC, whose benefit in acute respiratory failure has been proven, is also widely and successfully used in COVID-19 patients. Comprehensive randomized studies are required to demonstrate the effect of HFNC use on intubation requirement and mortality.

Keywords

• ventilation
• mortality
• covid-19
• respiratory failure
• pneumonia
• oxygen therapy