Ke Wang1, Wei Zhao2, Ji Li3, Weiwei Shu4, Jun Duan5. 1. Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China. 2. Department of Oncology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China. 3. Department of Thoracic Surgery, Chongqing Public Health Medical Center, Chongqing, 500106, People's Republic of China. 4. Department of Critical Care Medicine, Yongchuan Hospital of Chongqing Medical University, Xuanhua Road 429, Yongchuan District, Chongqing, 402160, People's Republic of China. shuweiwei361@163.com. 5. Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Youyi Road 1, Yuzhong District, Chongqing, 400016, People's Republic of China. duanjun412589@163.com.
Abstract
BACKGROUND: The outbreak of a novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) is currently ongoing in China. Most of the critically ill patients received high-flow nasal cannula (HFNC) oxygen therapy. However, the experience of HFNC in this population is lacking. METHODS: We retrospectively screened 318 confirmed patients with NCIP in two hospitals of Chongqing, China, from January 1st to March 4th, 2020. Among them, 27 (8.4%) patients experienced severe acute respiratory failure including 17 patients (63%) treated with HFNC as first-line therapy, 9 patients (33%) treated with noninvasive ventilation (NIV) and one patient (4%) treated with invasive ventilation. HFNC failure was defined by the need of NIV or intubation as rescue therapy. RESULTS: Of the 17 HFNC patients, 7 (41%) experienced HFNC failure. The HFNC failure rate was 0% (0/6) in patients with PaO2/FiO2 > 200 mm Hg vs. 63% (7/11) in those with PaO2/FiO2 ≤ 200 mm Hg (p = 0.04). Compared with baseline data, the respiratory rate significantly decreased after 1-2 h of HFNC in successful group [median 26 (IQR: 25-29) vs. 23 (22-25), p = 0.03]. However, it did not in the unsuccessful group. After initiation of NIV as rescue therapy among the 7 patients with HFNC failure, PaO2/FiO2 significantly improved after 1-2 h of NIV [median 172 (150-208) mmHg vs. 114 (IQR: 79-130) under HFNC, p = 0.04]. However, two out of seven (29%) patients with NIV as rescue therapy ultimately received intubation. Among the 27 patients with severe acute respiratory failure, four patients were eventually intubated (15%). CONCLUSIONS: Our study indicated that HFNC was the most common ventilation support for patients with NCIP. Patients with lower PaO2/FiO2 were more likely to experience HFNC failure.
BACKGROUND: The outbreak of a novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) is currently ongoing in China. Most of the critically illpatients received high-flow nasal cannula (HFNC) oxygen therapy. However, the experience of HFNC in this population is lacking. METHODS: We retrospectively screened 318 confirmed patients with NCIP in two hospitals of Chongqing, China, from January 1st to March 4th, 2020. Among them, 27 (8.4%) patients experienced severe acute respiratory failure including 17 patients (63%) treated with HFNC as first-line therapy, 9 patients (33%) treated with noninvasive ventilation (NIV) and one patient (4%) treated with invasive ventilation. HFNC failure was defined by the need of NIV or intubation as rescue therapy. RESULTS: Of the 17 HFNC patients, 7 (41%) experienced HFNC failure. The HFNC failure rate was 0% (0/6) in patients with PaO2/FiO2 > 200 mm Hg vs. 63% (7/11) in those with PaO2/FiO2 ≤ 200 mm Hg (p = 0.04). Compared with baseline data, the respiratory rate significantly decreased after 1-2 h of HFNC in successful group [median 26 (IQR: 25-29) vs. 23 (22-25), p = 0.03]. However, it did not in the unsuccessful group. After initiation of NIV as rescue therapy among the 7 patients with HFNC failure, PaO2/FiO2 significantly improved after 1-2 h of NIV [median 172 (150-208) mmHg vs. 114 (IQR: 79-130) under HFNC, p = 0.04]. However, two out of seven (29%) patients with NIV as rescue therapy ultimately received intubation. Among the 27 patients with severe acute respiratory failure, four patients were eventually intubated (15%). CONCLUSIONS: Our study indicated that HFNC was the most common ventilation support for patients with NCIP. Patients with lower PaO2/FiO2 were more likely to experience HFNC failure.
Authors: João João Mendes; José Artur Paiva; Filipe Gonzalez; Paulo Mergulhão; Filipe Froes; Roberto Roncon; João Gouveia Journal: Rev Bras Ter Intensiva Date: 2022-01-24
Authors: William E Soares; Elizabeth M Schoenfeld; Paul Visintainer; Tala Elia; Venkatrao Medarametla; David A Schoenfeld; Ashley Deutsch; Doug Salvador; Diane Dietzen; Mark A Tidswell; Peter A DePergola; Peter St Marie; Lauren M Westafer Journal: J Hosp Med Date: 2020-12 Impact factor: 2.960
Authors: Job van Steenkiste; Michael C van Herwerden; Dolf Weller; Christiaan J van den Bout; Rikje Ruiter; Jan G den Hollander; Rachida El Moussaoui; Gert T Verhoeven; Charlotte van Noord; Marinus A van den Dorpel Journal: Heart Lung Date: 2021-05-25 Impact factor: 2.210
Authors: Denise Battaglini; Chiara Robba; Lorenzo Ball; Pedro L Silva; Fernanda F Cruz; Paolo Pelosi; Patricia R M Rocco Journal: Br J Anaesth Date: 2021-06-03 Impact factor: 11.719