Predictors of high flow oxygen therapy failure in COVID-19-related severe hypoxemic respiratory failure.
COVID-19
acute respiratory distress syndrome (ARDS)
high flow nasal cannula (HFNC)
intubation
respiratory failure
Journal
Journal of thoracic disease
ISSN: 2072-1439
Titre abrégé: J Thorac Dis
Pays: China
ID NLM: 101533916
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
received:
20
08
2021
accepted:
21
01
2022
entrez:
16
5
2022
pubmed:
17
5
2022
medline:
17
5
2022
Statut:
ppublish
Résumé
During COVID-19 pandemic, people who developed pneumonia and needed supplemental oxygen, where treated with low-flow oxygen therapy systems and non-invasive methods, including oxygen therapy using high flow nasal cannula (HFNC) and the application of bi-level or continuous positive airway pressure (BiPAP or CPAP). We aimed to investigate the outcomes of critical COVID-19 patients treated with HFNC and unveil predictors of HFNC failure. We retrospectively enrolled patients admitted to COVID-19 wards and treated with HFNC for COVID-19-related severe hypoxemic respiratory failure. The primary outcome of this study was treatment failure, such as the composite of intubation or death during hospital stay. The association between treatment failure and clinical features was evaluated using logistic regression models. One hundred thirty-two patients with a median (IQR) PaO HFNC treatment was successful in almost half of the patients with severe COVID-19-related acute hypoxemic respiratory failure (AHRF). The presence of dyspnea and high serum Urea levels on admission are closely related to HFNC failure.
Sections du résumé
Background
UNASSIGNED
During COVID-19 pandemic, people who developed pneumonia and needed supplemental oxygen, where treated with low-flow oxygen therapy systems and non-invasive methods, including oxygen therapy using high flow nasal cannula (HFNC) and the application of bi-level or continuous positive airway pressure (BiPAP or CPAP). We aimed to investigate the outcomes of critical COVID-19 patients treated with HFNC and unveil predictors of HFNC failure.
Methods
UNASSIGNED
We retrospectively enrolled patients admitted to COVID-19 wards and treated with HFNC for COVID-19-related severe hypoxemic respiratory failure. The primary outcome of this study was treatment failure, such as the composite of intubation or death during hospital stay. The association between treatment failure and clinical features was evaluated using logistic regression models.
Results
UNASSIGNED
One hundred thirty-two patients with a median (IQR) PaO
Conclusions
UNASSIGNED
HFNC treatment was successful in almost half of the patients with severe COVID-19-related acute hypoxemic respiratory failure (AHRF). The presence of dyspnea and high serum Urea levels on admission are closely related to HFNC failure.
Identifiants
pubmed: 35572875
doi: 10.21037/jtd-21-1373
pii: jtd-14-04-851
pmc: PMC9096326
doi:
Types de publication
Journal Article
Langues
eng
Pagination
851-856Subventions
Organisme : British Heart Foundation
ID : FS/18/5/33319
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00019/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00019/2
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00019/4
Pays : United Kingdom
Informations de copyright
2022 Journal of Thoracic Disease. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interests: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-21-1373/coif). The authors have no conflicts of interest to declare.
Références
Chest. 2017 Apr;151(4):764-775
pubmed: 28089816
JAMA. 2020 Aug 25;324(8):782-793
pubmed: 32648899
Eur Respir J. 2021 Apr 15;57(4):
pubmed: 33692120
Ann Intensive Care. 2021 Feb 27;11(1):37
pubmed: 33638752
Respir Care. 2021 Jun;66(6):909-919
pubmed: 33328179
JAMA. 2021 May 4;325(17):1731-1743
pubmed: 33764378
Pathog Glob Health. 2021 Jun;115(4):243-249
pubmed: 33645468
BMJ Open Respir Res. 2020 Aug;7(1):
pubmed: 32847947
Front Med (Lausanne). 2020 Dec 08;7:607821
pubmed: 33425951
BMC Pulm Med. 2020 Dec 24;20(1):324
pubmed: 33357219
J Intensive Care. 2021 Mar 5;9(1):23
pubmed: 33673863
Crit Care. 2017 Jul 12;21(1):184
pubmed: 28701227
Lancet Respir Med. 2021 Aug;9(8):933-936
pubmed: 33915103
Chest. 2020 Nov;158(5):1992-2002
pubmed: 32681847
N Engl J Med. 2015 Jun 4;372(23):2185-96
pubmed: 25981908
Am J Emerg Med. 2021 Jan;39:154-157
pubmed: 33067061
Am J Respir Crit Care Med. 2020 Oct 1;202(7):1039-1042
pubmed: 32758000
EClinicalMedicine. 2020 Nov;28:100570
pubmed: 33043285
Lancet. 2021 Jul 17;398(10296):223-237
pubmed: 34274064
Crit Care. 2021 May 25;25(1):175
pubmed: 34034782
Cochrane Database Syst Rev. 2021 Mar 4;3:CD010172
pubmed: 33661521
JAMA. 2012 Jun 20;307(23):2526-33
pubmed: 22797452