The value of high‐flow nasal cannula oxygen therapy in treating novel coronavirus pneumonia

Abstract Background Coronavirus disease- 2019 (COVID-19) related to acute respiratory distress syndrome (ARDS) caused by the highly infectious SARS-CoV-2 novel coronavirus is a major cause of death during the pandemic period. Here we aim to present the retrospective data analysis of extubation success to High Flow Nasal Cannula Oxygen Therapy (HFNO) in COVID-19 ARDS patients. Methods The data of 22 laboratory-confirmed COVID-19 ARDS patients who were extubated to HFNO therapy at an intensive care unit (ICU) were analyzed. Respiratory variables as well as demographic characteristics were collected on admission. The mechanical ventilation volumes and pressures together with blood gas measurements were recorded during the intubation period. HFNO flow rate, FiO2, and oxygenation variables were collected 5 consecutive days after extubation. The reintubation rate within the 5 days following planned extubation, duration of ICU stay, and mortality were recorded. Results Among 22 patients, 16 were male (72.7%) and the mean age was 69.9 ± 13,2 years with the highest comorbidity being hypertension (59.1%). The duration between symptom initiation to ICU admission was 6.5 ± 7,9 days where nearly all patients were intubated on the same day. Twenty patients were successfully extubated to HFNO and 2 patients experienced reintubation. The mean duration of HFNO treatment was 4.8 ± 3.6 days and the length of ICU stay was 17.4 ± 6 days. The ICU mortality ratio of this complete data was 13.6% (3/22). Conclusion Among high-risk ARDS COVID-19 patients who have undergone extubation, HFNO therapy should be considered for preventing reintubation and post-extubation respiratory failure.

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The Value of High-flow Nasal Cannula Oxygen Therapy in Treating Patients With Severe Novel Coronavirus Pneumonia

10.21203/rs.3.rs-44745/v1 ◽

2020 ◽

Author(s):

Xiao-bao Teng ◽

Ya Shen ◽

Ming-feng Han ◽

Gang Yang ◽

Lei Zha ◽

...

Keyword(s):

Length Of Stay ◽

Oxygen Therapy ◽

Therapy Group ◽

Oxygenation Index ◽

High Flow ◽

Nasal Cannula ◽

High Flow Nasal Cannula ◽

Early Application ◽

Wbc Count ◽

Novel Coronavirus

Abstract Objective This study aimed to investigate the value of high-flow nasal cannula (HNFC) oxygen therapy in treating patients with severe novel coronavirus pneumonia (COVID-19). Methods The clinical data of 22 patients with severe COVID-19 were collected. The heart rate (HR), respiratory rate (RR) and oxygenation index (PO2/FiO2) at 0, 6, 24 and 72 hours after treatment were compared between the HFNC oxygen therapy group and the conventional oxygen therapy (COT) group. In addition, the white blood cell (WBC) count, lymphocyte (L) count, C-reactive protein (CRP) and procalcitonin (PCT) were compared before and at 72 hours after oxygen therapy treatment. Results Of the included patients, 12 were assigned to the HFNC oxygen therapy group and 10 were assigned to the COT group. The differences in HR, RR, PaO2/FiO2, WBC, L, CRP and PCT at 0 hours between the two groups were not statistically significant. At 6 hours after treatment with the two oxygen therapies, HR, RR and PaO2/FiO2 were better in the HFNC oxygen therapy group than in the COT group (p < 0.05), while at 24 and 72 hours after treatment with the two oxygen therapies, PaO2/FiO2 was better in the HFNC oxygen therapy group than in the COT group (p < 0.05), but the differences in HR and RR were not statistically significant. At 72 hours after treatment, L and CRP had significantly improved in the HFNC oxygen therapy group compared with the COT group, but the differences in WBC and PCT were not statistically significant. The length of stay in the intensive care unit (ICU) and the total length of hospitalization were shorter in the HFNC oxygen therapy group than in the COT group, and the differences between the two groups were statistically significant. Conclusion Compared with COT, early application of HFNC oxygen therapy in patients with severe COVID-19 can significantly improve oxygenation and RR, and HFNC oxygen therapy can improve the infection indexes of patients and reduce the length of stay in the ICU of patients. Therefore, it has high clinical application value.

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