The outcome of early use of high-velocity nasal insufflation in acute respiratory failure complicating coronavirus disease 2019

Abstract

Background High-flow nasal cannula showed success in some coronavirus disease 2019 (COVID-19) patients. High-velocity nasal insufflation (Hi-VNI) is a refined form of high-flow nasal cannula that delivers heated and humidified gas with high velocity through a simple small-bore nasal cannula. Objective To assess the impact of early use of Hi-VNI in improving hypoxemia and respiratory distress and its effect on the length of ICU stay in COVID-19 patients presented with acute respiratory failure. Patients and methods In total, 30 patients with confirmed COVID-19 presented with respiratory failure admitted to intensive care of COVID-19 zone were recruited to the study from October 2021 to February 2022. They were categorized into two groups: early and late Hi-VNI groups according to whether the shift to Hi-VNI occurred after low-flow nasal cannula or non-rebreathing mask, respectively. Results Successful outcome was achieved in 73.3% in early Hi-VNI group versus 53.3% in late Hi-VNI group. Regarding successful outcome, the duration of Hi-VNI and ICU stay was significantly (P <0.001) lower in early Hi-VNI group. Higher inflammatory markers and lymphopenia are predictors of failure. Conclusion The early use of Hi-VNI in hypoxemic respiratory failure of COVID-19 achieved better improvement of respiratory distress, oxygenation, and shorter ICU stay.

Keywords

• acute respiratory failure
• coronavirus disease 2019
• high-velocity nasal insufflation