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

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

Failure of High Flow Nasal Cannula and Subsequent Intubation Is Associated With Increased Mortality as Compared to Failure of Non-Invasive Ventilation and Mechanical Ventilation Alone: A Real-World Retrospective Analysis

2020 ◽  
pp. 088506662096804
Author(s):  
David C. Miller ◽  
Jie Pu ◽  
David Kukafka ◽  
Christian Bime
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Retrospective Analysis ◽  
Real World ◽  
High Flow ◽  
Nasal Cannula ◽  
Invasive Ventilation ◽  
High Flow Nasal Cannula ◽  
Non Invasive ◽  
Non Invasive Ventilation

Background: Despite the increasing use of high flow nasal cannula oxygenation systems (HFNC) in clinical practice, little is known about its role in all cause respiratory failure as compared to traditional non-invasive ventilation (BiPAP). Furthermore, the effect of HFNC on mortality is unknown. Methods: We conducted a retrospective analysis of 49,853 patients with respiratory failure treated with non-invasive respiratory support (HFNC or BiPAP) and/or invasive mechanical ventilation (IMV) between 2017 and 2018. Results: Patients initially treated with HFNC who underwent subsequent intubation and IMV had a higher mortality rate as compared to patients who were initially treated with BiPAP and underwent subsequent intubation and IMV (34.8% vs 26.3%, p < 0.0001, OR 1.49, 95% CI 1.26,1.76). Patients first treated with HFNC who underwent subsequent intubation and IMV had a significantly increased mortality compared to patients who underwent immediate intubation and IMV (34.8% vs. 21.5%, p ≤ 0.0001, OR 1.94, 95% CI 1.67, 2.27). Stratified based on ICD-10 diagnosis, patients with a diagnosis of COPD exacerbation or heart failure treated with HFNC and subsequent intubation and IMV had higher mortality as compared to those treated with immediate IMV alone. This trend did not hold true for patients with a diagnosis of pneumonia. Conclusion: In a real-world retrospective analysis, use of HFNC was associated with increased mortality as compared to BiPAP and IMV alone. Further study is needed to confirm these associations.

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

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.

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

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.

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

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.

Use of High-Flow Nasal Cannula in Patients With Pneumonia and Hypoxemic Respiratory Failure at Altitudes Above 2600 m: What Is the Best Predictor of Success?

2021 ◽  
pp. 088506662110575
Author(s):  
Molano Franco Daniel ◽  
Gómez Duque Mario ◽  
Beltrán Edgar ◽  
Villabon Mario ◽  
Hurtado Alejandra ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Respiratory Rate ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Multicenter Cohort Study ◽  
Hypoxemic Respiratory Failure ◽  
Severity Scores ◽  
High Flow Oxygen

Introduction: The use of high-flow nasal cannulas (HFNC) in patients with hypoxemic ventilatory failure reduces the need for mechanical ventilation and does not increase mortality when intubation is promptly applied. The aim of the study is to describe the behavior of HFNC in patients who live at high altitudes, and the performance of predictors of success/failure of this strategy. Methods: Prospective multicenter cohort study, with patients aged over 18 years recruited for 12 months in 2020 to 21. All had a diagnosis of hypoxemic respiratory failure secondary to pneumonia, were admitted to intensive care units, and were receiving initial management with a high-flow nasal cannula. The variables assessed included need for intubation, mortality in ICU, and the validation of SaO2, respiratory rate (RR) and ROX index (IROX) as predictors of HFNC success / failure. Results: One hundred and six patients were recruited, with a mean age of 59 years and a success rate of 74.5%. Patients with treatment failure were more likely to be obese (BMI 27.2 vs 25.5; OR: 1.03; 95% CI: .95-1.1) and had higher severity scores at admission (APACHE II 12 vs 20; OR 1.15; 95% CI: 1.06-1.24). Respiratory rates after 12 (AUC .81 CI: .70-.92) and 18 h (AUC .85 CI: .72-0.90) of HFNC use were the best predictors of failure, performing better than those that included oxygenation. ICU mortality was higher in the failure group (6% vs 29%; OR 8.8; 95% CI:1.75-44.7). Conclusions: High-flow oxygen cannula therapy in patients with hypoxemic respiratory failure living at altitudes above 2600 m is associated with low rates of therapy failure and a reduced need for mechanical ventilation in the ICU. The geographical conditions and secondary physiological changes influence the performance of the traditionally validated predictors of therapy success. Respiratory rate <30 proved to be the best indicator of early success of the device at 12 h of use.

scholarly journals High flow nasal cannula oxygen therapy in adults with COVID-19 respiratory failure. A case report

2020 ◽  
Vol 90 (2) ◽  
Author(s):  
Vasileios Karamouzos ◽  
Fotini Fligou ◽  
Charalambos Gogos ◽  
Dimitrios Velissaris
Keyword(s):  
Respiratory Failure ◽  
Oxygen Therapy ◽  
Virus Disease ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Non Invasive ◽  
Corona Virus ◽  
Non Invasive Ventilation ◽  
Hypoxic Respiratory Failure

The novel corona virus (SARS-CoV-2) continuous to spread around the globe causing high mortality, tremendous stress on healthcare systems and an unprecedented disruption of everyday life with unpredictable socioeconomic ramifications. The diseaseis typically affecting the respiratory system and some patients will develop refractory hypoxemic respiratory insufficiency requiring mechanical ventilation. The role of non-invasive ventilation (NIV), high flow nasal cannula (HFNC) or continuous positive airway pressure devices (C-PAP) in the treatment of the 2019 corona virus disease (COVID-19) is not yet clear. We hereby report a case of a 44-year-old COVID-19 positive male patient suffering from hypoxic respiratory failure that was successfully treated with high flow nasal cannula oxygen therapy in a negative pressure intensive care room. Although specific criteria for the use of high flow nasal canula devices COVID-19 are not available at this time, clinicians could use this non-invasive modality as analternative method of respiratory support in selected patients presenting with respiratory failure.

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