COVID-19 ARDS Patients Successfully Extubated to Extubated to High-Flow Nasal Cannula Oxygen Therapy: A Retrospective Analysis

Abstract

Objective:The acute respiratory distress syndrome (ARDS)-associated coronavirus disease-2019 (COVID-19), caused by the highly contagious severe acute respiratory syndrome coronavirus 2 novel coronavirus, is a major cause of death during the pandemic period. Here, we aim to present a retrospective data analysis of the success of extubation to high-flow nasal oxygen (HFNO) among COVID-19 ARDS patients.Materials and Methods:The data of 22 COVID-19 ARDS patients who were laboratory confirmed and extubated on HFNO while under intubation in the intensive care unit (ICU) were analyzed. Respiratory variables and demographic characteristics were collected at admission. During the intubation period, mechanical ventilation volumes and pressures and blood gas measurements were recorded. HFNO flow rate, FiO2, and oxygenation variables were collected for 5 days after extubation. After the planned extubation, the 5-day reintubation rate, length of stay in the ICU, and mortality were recorded.Results:Sixteen of 22 patients were male (72.7%). The mean age was 69.9±13.2 years and the highest comorbidity was hypertension (59.1%). The time between symptom onset and admission to the ICU was 6.5±7.9 days. Almost all patients were intubated on the same day. Twenty patients were successfully extubated to HFNO. Two patients experienced reintubation. The mean duration of HFNO treatment and length of stay in the ICU were 17.4±6 and 4.8±3.6 days, respectively. The ICU mortality rate of these complete data was 13.6% (3/22).Conclusion:In high-risk COVID-19 ARDS patients undergoing extubation, HFNO therapy should be considered to prevent respiratory failure after reintubation and post-extubation.

Keywords

• acute respiratory distress syndrome
• covid-19
• extubation
• high-flow nasal cannula oxygen therapy
• weaning