Patients with Acute Respiratory Failure Who Fail High Flow Nasal Cannula Before Intubation Have a Higher Mortality Compared to Invasive Mechanical Ventilation Alone

Abstract Introduction: The use of a high-flow nasal cannula as an alternative treatment for acute respiratory failure can reduce the need for invasive mechanical ventilation and the duration of hospital stays. Objective: The present study aimed to describe the use of a high-flow nasal cannula in pediatric asthmatic patients with acute respiratory failure and suspected COVID-19. Methods: To carry out this research, data were collected from medical records, including three patients with asthma diagnoses. The variables studied were: personal data (name, age in months, sex, weight, and color), clinical data (physical examination, PRAM score, respiratory rate, heart rate, and peripheral oxygen saturation), diagnosis, history of the current disease, chest, and laboratory radiography (arterial blood gases and reverse-transcriptase polymerase chain reaction). Clinical data were compared before and after using a high-flow nasal cannula. Results: After the application of the therapy, a gradual improvement in heart, respiratory rate, PaO2/FiO2 ratio, and the Pediatric Respiratory Assessment Measure score was observed. Conclusion: The simple and quick use of a high-flow nasal cannula in pediatric patients with asthma can be safe and efficient in improving their respiratory condition and reducing the need for intubation.

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High-flow nasal cannula versus noninvasive ventilation in the prevention of escalation to invasive mechanical ventilation in patients with acute hypoxemic respiratory failure

Egyptian Journal of Chest Diseases and Tuberculosis ◽

10.4103/ecdt.ecdt_12_20 ◽

2022 ◽

Vol 71 (1) ◽

pp. 81

Author(s):

ManalA Mahmoud ◽

Gamal Agmy ◽

Mohamed Adam ◽

EntsarH.M Hsanen

Keyword(s):

Mechanical Ventilation ◽

Respiratory Failure ◽

Noninvasive Ventilation ◽

Invasive Mechanical Ventilation ◽

High Flow ◽

Nasal Cannula ◽

High Flow Nasal Cannula ◽

Hypoxemic Respiratory Failure ◽

Acute Hypoxemic Respiratory Failure

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High Flow Nasal Cannula with warm humidified air versus Non-Invasive Mechanical Ventilation in Respiratory Failure type II

10.1183/1393003.congress-2017.pa2182 ◽

2017 ◽

Author(s):

Ioannis Papachatzakis ◽

Lemonia Velentza ◽

Sofoklis Kontogiannis ◽

Georgia Trakada

Keyword(s):

Mechanical Ventilation ◽

Respiratory Failure ◽

Invasive Mechanical Ventilation ◽

High Flow ◽

Nasal Cannula ◽

Type Ii ◽

High Flow Nasal Cannula ◽

Failure Type ◽

Non Invasive ◽

Humidified Air

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High flow nasal cannula oxygen and non-invasive mechanical ventilation in management of COVID-19 patients with acute respiratory failure: a retrospective observational study

Egyptian Journal of Bronchology ◽

10.1186/s43168-021-00063-0 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Amr Mounir Shoukri

Keyword(s):

Mechanical Ventilation ◽

Respiratory Failure ◽

Mortality Rate ◽

Endotracheal Intubation ◽

Invasive Mechanical Ventilation ◽

High Flow ◽

Nasal Cannula ◽

High Flow Nasal Cannula ◽

Hypoxemic Respiratory Failure ◽

Acute Hypoxemic Respiratory Failure

Abstract Background High flow nasal cannula oxygen (HFNCO) is a relatively new technique used to deliver oxygen in respiratory failure patients. This retrospective study is aiming to assess the role and benefits of using HFNCO compared to non-invasive ventilation (NIV) in management of patients with acute hypoxemic respiratory failure associated with coronavirus disease 2019 (COVID-19). Results A retrospective analysis of the files of 63 patients with COVID-19 and acute hypoxemic respiratory failure admitted to the intensive care unit (ICU), 37 patients received HFNCO as initial therapy, and 26 patients were primarily treated with NIV. There was no significant difference between the 2 groups in terms of baseline characteristics, laboratory tests, arterial blood gases, PaO2/FiO2 values, and vital signs. Re-assessment after 24 h of starting treatment with either HFNCO or NIV showed significant improvement (P<0.01) in the respiratory rate, heart rate, and oxygenation parameters. The magnitude of improvement of the vital signs and oxygenation was not significantly different between patients using HFNCO or NIV. Success rate of HFNCO was 86.4%, endotracheal intubation with invasive mechanical ventilation was required in 10.81% of patients, and mortality rate was 2.7%. Success rate of NIV was 84.6%, endotracheal intubation rate was 11.53%, and mortality rate was 3.8%. No significant difference (P>0.05) between the 2 groups as regards the duration of treatment, rate of endotracheal intubation with invasive mechanical ventilation, and mortality rate. Conclusion High flow nasal cannula oxygen (HFNCO) is effective in the management of acute hypoxemic respiratory failure associated with COVID-19. Its efficacy is similar to NIV, with no difference in the duration of treatment, endotracheal intubation rate, or mortality rate.

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High-flow Nasal Cannula therapy: A feasible treatment for vulnerable older COVID-19 patients on the wards

10.21203/rs.3.rs-34470/v2 ◽

2020 ◽

Author(s):

Job van Steenkiste ◽

Michael C. van Herwerden ◽

Dolf Weller ◽

Christiaan J. van den Bout ◽

Rikje Ruiter ◽

...

Keyword(s):

Mechanical Ventilation ◽

Respiratory Failure ◽

Invasive Mechanical Ventilation ◽

High Flow ◽

Nasal Cannula ◽

High Dose ◽

High Flow Nasal Cannula ◽

Oxygen Administration ◽

Respiratory Management ◽

Vulnerable Elderly

Abstract Background: In the midst of the COVID-19 crisis, many frail elderly adults were admitted to our hospital with COVID-19. Some faced severe respiratory failure but were not eligible for invasive mechanical ventilation, due to frailty, functional status, comorbidity or wish of the patient. Our main objective was to investigate whether High-flow nasal cannula (HFNC) treatment on the wards could be an effective alternative treatment for these patients.Methods: A retrospective cohort study amongst COVID-19 adult patients with respiratory failure defined as persisting hypoxemia despite maximum conventional oxygen administration requiring invasive mechanical ventilation in the Intensive Care Unit (ICU) but being treated with HFNC as they were non-eligible due to frailty or wish of the patient.Results: The study included 32 patients between March 9th and May 1st, 2020. The median age was 79.0 years (74.5-83.0) with a median of three comorbidities (3-4) and a median Clinical Frailty Score of 4 out of 9 (3-6). The median SpO2/FiO2 Ratio was 157.5 indicating moderate ARDS. Overall survival rate in the HFNC cohort was 25%. Age (80.5 (78.0-84.3) vs 69.5 (65.5-74.3) p=0.0040) and hypertension (92% vs 25%, p=0.0008) were correlated with mortality.Conclusion: This study suggests that HFNC could be an effective last resort respiratory management strategy for respiratory failure in vulnerable elderly COVID-19 patients who failed on conventional high dose oxygen supply and are not eligible for invasive mechanical ventilation.

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High-Flow Nasal Cannula therapy: A Feasible Treatment in Vulnerable Older COVID-19 Patients on the Wards

10.21203/rs.3.rs-34470/v1 ◽

2020 ◽

Author(s):

Job van Steenkiste ◽

Michael C. van Herwerden ◽

Dolf Weller ◽

Christiaan J. van den Bout ◽

Rikje Ruiter ◽

...

Keyword(s):

Mechanical Ventilation ◽

Respiratory Failure ◽

Invasive Mechanical Ventilation ◽

High Flow ◽

Nasal Cannula ◽

High Dose ◽

High Flow Nasal Cannula ◽

Oxygen Administration ◽

Respiratory Management ◽

Vulnerable Elderly

Abstract Background: In the midst of the COVID-19 crisis, many frail elderly were admitted to our hospital with COVID-19. We sought a treatment for those who had severe respiratory failure but were not eligible for invasive mechanical ventilation, due to frailty, functional status, comorbidity or wish of the patient. We started with applying High-flow nasal cannula (HFNC) treatment on the wards.Methods: A retrospective cohort study amongst COVID-19 adult patients with respiratory failure defined as persisting hypoxemia despite maximum conventional oxygen administration requiring invasive mechanical ventilation at the Intensive Care Unit (ICU) but being treated with HFNC as they were non-eligible due to frailty or wish of the patient.Results: We included 32 patients between March 9 and May 1, 2020. The median age was 79.0 years (74.5-83.0) with a median of three comorbidities (3-4) and a median Clinical Frailty Score of 4 out of 9 (3-6). The median SPO2/FiO2 Ratio was 157.5 indicating moderate ARDS. Overall survival rate in the HFNC cohort was 25%. Age (80.5 (78.0-84.3) vs 69.5 (65.5-74.3) p=0.0040) and hypertension (92% vs 25%, p=0.0008) were associated with mortality.Conclusion: HFNC can be used as a last resort respiratory management strategy in vulnerable elderly COVID-19 patients in respiratory failure on the wards who failed on conventional high dose oxygen supply and are not eligible for invasive mechanical ventilation.

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