scholarly journals Predictive factors for high-flow nasal cannula failure in acute hypoxemic respiratory failure in an intensive care unit

Lung India ◽  
2022 ◽  
Vol 39 (1) ◽  
pp. 5
Author(s):  
Chung-Tat Lun ◽  
Chi-Kin Leung ◽  
Hoi-Ping Shum ◽  
Sheung-On So
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Predictive Factors ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure

scholarly journals High Flow Nasal Cannula Oxygen In Non-Critical Care Units In Patients Infected With SARS-CoV-2 Who Are Not Suitable For Intensive Care Unit

2021 ◽  
Author(s):  
Laura Bouetard ◽  
Dorothée Vignes ◽  
Dorra Braham ◽  
Raluca Sterpu ◽  
Charles Damoisel ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Respiratory Failure ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Hypoxemic Respiratory Failure ◽  
Old Patients ◽  
Improve Patient Survival

Abstract Background:High-flow nasal cannula (HFNC) is a recent respiratory support technique used for patients with hypoxemic respiratory failure; its use usually takes place in critical care wards. During the second wave of Covid-19, almost 400 000 people were hospitalized in France, and intensive care units were overwhelmed. For patients who did not meet criteria for admission to an intensive care unit because of their age or their medical background, we proposed HFNC in non-critical care unit instead of standard oxygen therapy to improve patient survival and comfort.Objectives: To describe characteristics and outcomes of patients infected with SARS-CoV-2 with HFNC in non-critical care wards between September 2020 and June 2021.Methods: This was a single-center, retrospective cohort study conducted between September and June 2021 in Clamart Hospital, France. Patients infected with SARS-CoV-2 confirmed, who were not suitable for intensive care unit escalation, and who were proposed HFNC because of respiratory failure were assessed.Results:Thirty-one patients with SARS-CoV-2 were included, median age 87.0 years (interquartile range (IQR), 82.0-91.0), 52% men. Nineteen (61%) patients were OMS score 0, i.e. no disability in daily-life activities. HNFC was started a median of 3 days (IQR, 1-5.5) after hospitalization. Overall, median duration of HNFC was 6 days (IQR, 4-10). Eleven patients (35.5%) survived and were discharged from hospital.Conclusions:Our experience of HFNC for patients with COVID-19 outside of a critical care environment because of their age and comorbidities is positive allowing survival of 35% of old patients not admitted to an intensive care unit. Trial registration:Not applicable

scholarly journals SpO2/FiO2 as a predictor of high flow nasal cannula outcomes in children with acute hypoxemic respiratory failure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ga Eun Kim ◽  
Sun Ha Choi ◽  
Mireu Park ◽  
Jae Hwa Jung ◽  
Myeongjee Lee ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Predictive Factors ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Fraction Of Inspired Oxygen ◽  
Oxygen Ratio ◽  
Inspired Oxygen

AbstractThe high-flow nasal cannula (HFNC) is a useful treatment modality for acute hypoxemic respiratory failure (AHRF) in children. We compared the ability of the oxygen saturation to fraction of inspired oxygen ratio (S/F) and arterial oxygen partial pressure to fraction of inspired oxygen ratio (P/F) to predict HFNC outcomes in children with AHRF. This study included children treated with HFNC due to AHRF from April 2013 to March 2019 at the Severance Children’s Hospital. HFNC failure was defined as the need for mechanical ventilation. Trends of S/F and P/F during HFNC were analyzed. To predict HFNC outcomes, a nomogram was constructed based on predictive factors. A total of 139 patients with arterial blood gas data were included in the S/F and P/F analyses. S/F < 230 at initiation showed high prediction accuracy for HFNC failure (area under the receiver operating characteristic curve: 0.751). Univariate analyses identified S/F < 230 at HFNC initiation and < 200 at 2 h (odds ratio [OR] 12.83, 95% CI 5.06–35.84), and hemato-oncologic disease (OR 3.79, 95% CI 1.12–12.78) as significant predictive factors of HFNC failure. The constructed nomogram had a highly predictive performance, with a concordance index of 0.765 and 0.831 for the exploratory and validation groups, respectively. S/F may be used as a predictor of HFNC outcomes. Our nomogram with S/F for HFNC failure within 2 h may prevent delayed intubation in children with AHRF.

scholarly journals Surgical mask on top of high-flow nasal cannula improves oxygenation in critically ill COVID-19 patients with hypoxemic respiratory failure

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Virginie Montiel ◽  
Arnaud Robert ◽  
Annie Robert ◽  
Anas Nabaoui ◽  
Tourneux Marie ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Critically Ill ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Hypoxemic Respiratory Failure ◽  
Mixed Intensive Care Unit ◽  
Pre Treatment

Abstract Objective Critically ill patients admitted in ICU because of COVID-19 infection display severe hypoxemic respiratory failure. The Surviving Sepsis Campaign recommends oxygenation through high-flow nasal cannula over non-invasive ventilation. The primary outcome of our study was to evaluate the effect of the addition of a surgical mask on a high-flow nasal cannula system on oxygenation parameters in hypoxemic COVID-19 patients admitted in ICU who do not require urgent intubation. The secondary outcomes were relevant changes in PaCO2 associated with clinical modifications and patient’s feelings. Design We prospectively assessed 21 patients admitted in our mixed Intensive Care Unit of the Cliniques Universitaires Saint Luc. Main results While FiO2 was unchanged, we demonstrate a significant increase of PaO2 (from 59 (± 6), to 79 mmHg (± 16), p < 0.001), PaO2/FiO2 from 83 (± 22), to 111 (± 38), p < 0.001) and SaO2 (from 91% (± 1.5), to 94% (± 1.6), p < 0.001), while the patients were under the surgical mask. The SpO2 returned to pre-treatment values when the surgical mask was removed confirming the effect of the device rather than a spontaneous positive evolution. Conclusion A surgical mask placed on patient’s face already treated by a High-flow nasal cannula device improves COVID-19 patient’s oxygenation admitted in Intensive Care Unit for severe hypoxemic respiratory failure without any clinically relevant side.

scholarly journals The Double-Trunk Mask Improves Oxygenation During High-Flow Nasal Cannula Therapy for Acute Hypoxemic Respiratory Failure

2019 ◽  
Vol 64 (8) ◽  
pp. 908-914 ◽  
Author(s):  
Frédéric Duprez ◽  
Arnaud Bruyneel ◽  
Shahram Machayekhi ◽  
Marie Droguet ◽  
Yves Bouckaert ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure

Is high-flow nasal cannula oxygenation more effective than noninvasive ventilation or conventional oxygen therapy in treating acute hypoxemic respiratory failure in COVID-19 patients?

2020 ◽  
Vol 54 ◽  
Author(s):  
Cary Amiel G. Villanueva ◽  
Marie Gene D. Cruz ◽  
Lia M. Palileo-Villanueva
Keyword(s):  
Respiratory Failure ◽  
Noninvasive Ventilation ◽  
Observational Studies ◽  
Oxygen Therapy ◽  
High Flow ◽  
Nasal Cannula ◽  
Respiratory Support ◽  
High Flow Nasal Cannula ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure

KEY FINDINGSVery low-quality evidence suggests lower mortality (based on five observational studies) but higher failurerate of respiratory support (based on two observational studies) in COVID-19 patients given high-flow nasalcannula (HFNC) oxygen compared with noninvasive ventilation (NIV) and conventional oxygenation therapy.Randomized controlled trials (RCT) are urgently needed in this area.• Respiratory failure accounts for about half of deaths in patients with COVID-19.• High-flow nasal cannula (HFNC) oxygen therapy reduces the need for escalating respiratory support and improvespatient comfort compared with conventional oxygen therapy among those with acute respiratory failure.• Mortality was consistently lower in COVID-19 patients who received HFNC rather than NIV or conventionaloxygen therapy (COT) across 5 very low-quality retrospective observational studies from China.• Several international guidelines recommend the use of HFNC oxygen therapy in COVID-19 patients whodevelop acute hypoxemic respiratory failure. However, local guidelines from the Philippine Society forMicrobiology and Infectious Diseases (PSMID) and the Philippine College of Chest Physicians (PCCP) recommendagainst HFNC due to risks of transmission and paucity of direct evidence for efficacy.• Additional infection control precautions, i.e. wearing a surgical mask over the cannula, and locating in a negativepressure room, are recommended whenever using HFNC or NIV.• There are at least two ongoing trials due to be completed by the second quarter of 2021 comparingHFNC oxygenation with NIV or COT in COVID-19 patients.

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