BACKGROUND: The role of high-flow nasal cannula oxygen therapy (HFNC) in respiratory management of acute exacerbation of interstitial pneumonia (AE-IP) is unknown. METHODS: We retrospectively reviewed patients with AE-IP who were admitted to our hospital from June 2009 - May 2015 and compared mortality, complications, sedatives and analgesia use, and oral intake between cohorts before (pre-HFNC: June 2009 - May 2012) and after (post-HFNC: June 2012 - May 2015) the introduction of HFNC. In the pre-HFNC cohort, standard oxygen therapy, noninvasive ventilation (NIV), and invasive mechanical ventilation (IMV) were used for respiratory management of AE-IP. In the post-HFNC cohort, HFNC was also used as an alternative to NIV in patients (I) who had refused NIV; (II) unable to cooperate, (III) intolerant to NIV, or (IV) who improved in respiratory parameters after NIV treatment for weaning. RESULTS: Fifty-three pre-HFNC patients and 43 post-HFNC patients were enrolled. Neither the baseline characteristics at admission nor the major pharmacotherapy for AE-IP differed between the two cohorts. Twenty-eight (52.8%) patients and 19 (44.2%) patients required any respiratory support, in pre- and post-HFNC cohort, respectively (P=0.40). After introduction of HFNC, it was used in 40% of the patients who required respiratory support and NIV use was significantly reduced from 49.1% to 16.3% (P<0.001). The post-HFNC cohort had significantly lower in-hospital mortality than the pre-HFNC cohort (27.9% vs. 49.1%, P=0.04). The incidence of complications was not significantly different between the two cohorts. The use of sedoanalgesia during respiratory support and the number of patients who discontinued oral intake for >24 hours were decreased after the introduction of HFNC (78.6% vs. 31.6%, P<0.001; 52.8% vs. 23.3%, P=0.003). CONCLUSIONS: HFNC might be a feasible option in respiratory management of AE-IP.
BACKGROUND: The role of high-flow nasal cannula oxygen therapy (HFNC) in respiratory management of acute exacerbation of interstitial pneumonia (AE-IP) is unknown. METHODS: We retrospectively reviewed patients with AE-IP who were admitted to our hospital from June 2009 - May 2015 and compared mortality, complications, sedatives and analgesia use, and oral intake between cohorts before (pre-HFNC: June 2009 - May 2012) and after (post-HFNC: June 2012 - May 2015) the introduction of HFNC. In the pre-HFNC cohort, standard oxygen therapy, noninvasive ventilation (NIV), and invasive mechanical ventilation (IMV) were used for respiratory management of AE-IP. In the post-HFNC cohort, HFNC was also used as an alternative to NIV in patients (I) who had refused NIV; (II) unable to cooperate, (III) intolerant to NIV, or (IV) who improved in respiratory parameters after NIV treatment for weaning. RESULTS: Fifty-three pre-HFNC patients and 43 post-HFNC patients were enrolled. Neither the baseline characteristics at admission nor the major pharmacotherapy for AE-IP differed between the two cohorts. Twenty-eight (52.8%) patients and 19 (44.2%) patients required any respiratory support, in pre- and post-HFNC cohort, respectively (P=0.40). After introduction of HFNC, it was used in 40% of the patients who required respiratory support and NIV use was significantly reduced from 49.1% to 16.3% (P<0.001). The post-HFNC cohort had significantly lower in-hospital mortality than the pre-HFNC cohort (27.9% vs. 49.1%, P=0.04). The incidence of complications was not significantly different between the two cohorts. The use of sedoanalgesia during respiratory support and the number of patients who discontinued oral intake for >24 hours were decreased after the introduction of HFNC (78.6% vs. 31.6%, P<0.001; 52.8% vs. 23.3%, P=0.003). CONCLUSIONS: HFNC might be a feasible option in respiratory management of AE-IP.
Authors: Judith Jacobi; Gilles L Fraser; Douglas B Coursin; Richard R Riker; Dorrie Fontaine; Eric T Wittbrodt; Donald B Chalfin; Michael F Masica; H Scott Bjerke; William M Coplin; David W Crippen; Barry D Fuchs; Ruth M Kelleher; Paul E Marik; Stanley A Nasraway; Michael J Murray; William T Peruzzi; Philip D Lumb Journal: Crit Care Med Date: 2002-01 Impact factor: 7.598
Authors: E W Ely; R Margolin; J Francis; L May; B Truman; R Dittus; T Speroff; S Gautam; G R Bernard; S K Inouye Journal: Crit Care Med Date: 2001-07 Impact factor: 7.598
Authors: I-Nae Park; Dong Soon Kim; Tae Sun Shim; Chae-Man Lim; Sang Do Lee; Younsuck Koh; Woo Sung Kim; Won Dong Kim; Se Jin Jang; Thomas V Colby Journal: Chest Date: 2007-03-30 Impact factor: 9.410
Authors: Harold R Collard; Bethany B Moore; Kevin R Flaherty; Kevin K Brown; Robert J Kaner; Talmadge E King; Joseph A Lasky; James E Loyd; Imre Noth; Mitchell A Olman; Ganesh Raghu; Jesse Roman; Jay H Ryu; David A Zisman; Gary W Hunninghake; Thomas V Colby; Jim J Egan; David M Hansell; Takeshi Johkoh; Naftali Kaminski; Dong Soon Kim; Yasuhiro Kondoh; David A Lynch; Joachim Müller-Quernheim; Jeffrey L Myers; Andrew G Nicholson; Moisés Selman; Galen B Toews; Athol U Wells; Fernando J Martinez Journal: Am J Respir Crit Care Med Date: 2007-06-21 Impact factor: 21.405
Authors: Curtis N Sessler; Mark S Gosnell; Mary Jo Grap; Gretchen M Brophy; Pam V O'Neal; Kimberly A Keane; Eljim P Tesoro; R K Elswick Journal: Am J Respir Crit Care Med Date: 2002-11-15 Impact factor: 21.405