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

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

European Journal of Clinical Investigation ◽

10.1111/eci.13435 ◽

2020 ◽

Author(s):

Xiao‐bao Teng ◽

Ya Shen ◽

Ming‐feng Han ◽

Gang Yang ◽

Lei Zha ◽

...

Keyword(s):

Oxygen Therapy ◽

High Flow ◽

Nasal Cannula ◽

High Flow Nasal Cannula ◽

Novel Coronavirus

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Comparison of high-flow nasal cannula and conventional oxygen therapy following extubation after pediatric cardiac surgery: a retrospective study

Kosuyolu Heart Journal ◽

10.51645/khj.2021.m92 ◽

2021 ◽

Author(s):

Ömer Faruk Şavluk ◽

Abdullah Arif Yılmaz ◽

Yasemin Yavuz ◽

Fatma Ukil Işıldak ◽

Babürhan Özbek ◽

...

Keyword(s):

Cardiac Surgery ◽

Heart Disease ◽

Retrospective Study ◽

Oxygen Therapy ◽

Therapy Group ◽

High Flow ◽

Nasal Cannula ◽

Pediatric Cardiac Surgery ◽

High Flow Nasal Cannula ◽

Group I

Objectives: Infants and children with congenital heart disease may develop respiratory failure in association with cardiac surgery or as a result of heart disease. In fact, the postextubation period in this group of patients can be complex and the use of continuous positive airway pressure or non-invasive ventilation may be necessary if conventional oxygen therapy is not sufficient. The aim of our study was to compare efficiency and outcomes of high-flow nasal cannula or conventional oxygen therapy post-extubation after pediatric cardiac surgery . Patients and Methods: A single centre retrospective study was conducted between January and december 2020 in our 12 beds pediatric cardiac intensive care unit. Patients were divided into two groups. In one group 45 patients (Group I), those who received high-flow nasal cannula after extubation, and in the other group 45 patients (Group II), those who received oxygen therapy with a mask after extubation. The aim of the study was to evaluate the relative efficacy of high flow nasal cannula and conventional oxygen therapy on PaCO2 ,PaO2 and PaO2/FiO2. Results: PaO2 values at 1, 6, 12, 24 and 48 h post-extubation were significantly higher in high-flow nasal cannula group (p<0,05). PaCO2 values were significantly lower in the high-flow nasal cannula group at 1, 6, 12, 24 and 48 h post-extubation (p=0,01). PaO2/FiO2 values in high-flow nasal cannula group at all-time points post-extubation were significantly higher than in conventional oxygen therapy group (p=0,01). Conclusion: High-flow nasal cannula is useful in decreasing PaCO2 and improving PaO2 in children following extubation after cardiac surgery. In addition, the simplicity of and tolerability to high-flow nasal cannula is also important. Although more expensive, the use of high-flow nasal cannula can be considered as a safe and effective alternative to conventional oxygen therapy following pediatric cardiac surgery.

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

10.21203/rs.3.rs-482283/v1 ◽

2021 ◽

Author(s):

GULCIN HILAL ALAY ◽

Perihan Ergin Ozcan ◽

Ozlem Polat ◽

Ilkay Anakli ◽

Gunseli Orhun ◽

...

Keyword(s):

Oxygen Therapy ◽

High Flow ◽

Nasal Cannula ◽

High Flow Nasal Cannula ◽

Icu Stay ◽

Retrospective Data Analysis ◽

Mortality Ratio ◽

The Mean ◽

Gas Measurements ◽

Novel Coronavirus

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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High-flow nasal cannula for reducing hypoxemic events in patients undergoing bronchoscopy: A systematic review and meta-analysis of randomized trials

PLoS ONE ◽

10.1371/journal.pone.0260716 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0260716

Author(s):

Chien-Ling Su ◽

Ling-Ling Chiang ◽

Ka-Wai Tam ◽

Tzu-Tao Chen ◽

Ming-Chi Hu

Keyword(s):

Systematic Review ◽

Partial Pressure ◽

Oxygen Therapy ◽

Therapy Group ◽

Weighted Mean Difference ◽

Meta Analysis ◽

High Flow ◽

Nasal Cannula ◽

Cochrane Library ◽

High Flow Nasal Cannula

Background Patients undergoing bronchoscopic procedures may develop hypoxemia and severe complications. High-flow nasal cannula (HFNC) may prevent hypoxemic events during bronchoscopy. We conducted a systematic review of randomized controlled trials (RCTs) to evaluate the effectiveness of HFNC in these patients. Methods We conducted a search in PubMed, Embase, and the Cochrane Library for RCTs published before November 2021. Individual effect sizes were standardized, and a meta-analysis was performed to calculate the pooled effect size using random-effects models. The primary outcome was the incidence of hypoxemic events (oxygen saturation [SpO2] < 90%) during bronchoscopy. Secondary outcomes included the incidence of interrupted bronchoscopy due to desaturation, lowest SpO2 during bronchoscopy, partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), end-tidal CO2 (EtCO2) at the end of bronchoscopy, and the incidence of intubation after the procedure. Results Five trials involving 257 patients were reviewed. The incidence of hypoxemic events was lower in the HFNC group than in the conventional oxygen therapy group (risk ratio, 0.25; 95% confidence interval [CI], 0.14–0.42). The lowest SpO2 during the procedure was significantly higher in the HFNC group than in the conventional oxygen therapy group (weighted mean difference [WMD], 7.12; 95% CI, 5.39–8.84). PaO2 at the end of the procedure was significantly higher in the HFNC group than in the conventional oxygen therapy group (WMD, 20.36; 95% CI, 0.30–40.42). The incidence of interrupted bronchoscopy due to desaturation, PaCO2 and EtCO2 at the end of the procedure, and the incidence of intubation after the procedure were not significantly different between groups. Conclusions HFNC may reduce the incidence of hypoxemic events and improve oxygenation in patients undergoing bronchoscopy.

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Modified high-flow nasal cannula oxygen therapy versus conventional oxygen therapy in patients undergoing bronchoscopy: a randomized clinical trial

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01744-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rui Wang ◽

Hai-Chao Li ◽

Xu-Yan Li ◽

Xiao Tang ◽

Hui-Wen Chu ◽

...

Keyword(s):

Clinical Trial ◽

Oxygen Therapy ◽

Therapy Group ◽

Controlled Trial ◽

Arterial Oxygen Saturation ◽

High Flow ◽

Nasal Cannula ◽

Arterial Oxygen ◽

High Flow Nasal Cannula ◽

Single Moment

Abstract Background Hypoxemia frequently occurs during bronchoscopy. High-flow nasal cannula (HFNC) oxygen therapy may be a feasible alternative to prevent the deterioration of gas exchange during bronchoscopy. With the convenience of clinical use in mind, we modified an HFNC using a single cannula. This clinical trial was designed to test the hypothesis that a modified HFNC would decrease the proportion of patients with a single moment of peripheral arterial oxygen saturation (SpO2) < 90% during bronchoscopy. Methods In this single-center, prospective randomized controlled trial, hospitalized patients in the respiratory department in need of diagnostic bronchoscopy were randomly assigned to a modified HFNC oxygen therapy group or a conventional oxygen therapy (COT) group. The primary outcome was the proportion of patients with a single moment of SpO2 < 90% during bronchoscopy. Results Eight hundred and twelve patients were randomized to the modified HFNC (n = 406) or COT (n = 406) group. Twenty-four patients were unable to cooperate or comply with bronchoscopy. Thus, 788 patients were included in the analysis. The proportion of patients with a single moment of SpO2 < 90% during bronchoscopy in the modified HFNC group was significantly lower than that in the COT group (12.5% vs. 28.8%, p < 0.001). There were no significant differences in the fraction of inspired oxygen between the two groups. The lowest SpO2 during bronchoscopy and 5 min after bronchoscopy in the modified HFNC group was significantly higher than that in the COT group. Multivariate analysis showed that a baseline forced vital capacity (FVC) < 2.7 L (OR, 0.276; 95% CI, 0.083–0.919, p = 0.036) and a volume of fluid instilled > 60 ml (OR, 1.034; 95% CI, 1.002–1.067, p = 0.036) were independent risk factors for hypoxemia during bronchoscopy in the modified HFNC group. Conclusions A modified HFNC could decrease the proportion of patients with a single moment of SpO2 < 90% during bronchoscopy. A lower baseline FVC and large-volume bronchoalveolar lavage may predict desaturation during bronchoscopy when using a modified HFNC. Trial registration ClinicalTrials. Gov: NCT02606188. Registered 17 November 2015.

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