tetano
Editor, Senior Moderator
Respir Res
. 2024 Mar 1;25(1):109.
doi: 10.1186/s12931-024-02671-y. Prognosis of mechanically ventilated patients with COVID-19 after failure of high-flow nasal cannula: a retrospective cohort study
Dong-Gon Hyun[SUP] 1 [/SUP], Su Yeon Lee[SUP] 1 [/SUP], Jee Hwan Ahn[SUP] 1 [/SUP], Sang-Bum Hong[SUP] 1 [/SUP], Chae-Man Lim[SUP] 1 [/SUP], Younsuck Koh[SUP] 1 [/SUP], Jin Won Huh[SUP] 2 [/SUP]
Affiliations
Background: There is an argument whether the delayed intubation aggravate the respiratory failure in Acute respiratory distress syndrome (ARDS) patients with coronavirus disease 2019 (COVID-19). We aimed to investigate the effect of high-flow nasal cannula (HFNC) failure before mechanical ventilation on clinical outcomes in mechanically ventilated patients with COVID-19.
Methods: This retrospective cohort study included mechanically ventilated patients who were diagnosed with COVID-19 and admitted to the intensive care unit (ICU) between February 2020 and December 2021 at Asan Medical Center. The patients were divided into HFNC failure (HFNC-F) and mechanical ventilation (MV) groups according to the use of HFNC before MV. The primary outcome of this study was to compare the worst values of ventilator parameters from day 1 to day 3 after mechanical ventilation between the two groups.
Results: Overall, 158 mechanically ventilated patients with COVID-19 were included in this study: 107 patients (67.7%) in the HFNC-F group and 51 (32.3%) in the MV group. The two groups had similar profiles of ventilator parameter from day 1 to day 3 after mechanical ventilation, except of dynamic compliance on day 3 (28.38 mL/cmH2O in MV vs. 30.67 mL/H2O in HFNC-F, p = 0.032). In addition, the HFNC-F group (5.6%) had a lower rate of ECMO at 28 days than the MV group (17.6%), even after adjustment (adjusted hazard ratio, 0.30; 95% confidence interval, 0.11-0.83; p = 0.045).
Conclusions: Among mechanically ventilated COVID-19 patients, HFNC failure before mechanical ventilation was not associated with deterioration of respiratory failure.
Keywords: COVID-19; Critical care outcomes; Mechanical ventilators; Noninvasive ventilation; Respiratory distress syndrome.
. 2024 Mar 1;25(1):109.
doi: 10.1186/s12931-024-02671-y. Prognosis of mechanically ventilated patients with COVID-19 after failure of high-flow nasal cannula: a retrospective cohort study
Dong-Gon Hyun[SUP] 1 [/SUP], Su Yeon Lee[SUP] 1 [/SUP], Jee Hwan Ahn[SUP] 1 [/SUP], Sang-Bum Hong[SUP] 1 [/SUP], Chae-Man Lim[SUP] 1 [/SUP], Younsuck Koh[SUP] 1 [/SUP], Jin Won Huh[SUP] 2 [/SUP]
Affiliations
- PMID: 38429645
- PMCID: PMC10905875
- DOI: 10.1186/s12931-024-02671-y
Background: There is an argument whether the delayed intubation aggravate the respiratory failure in Acute respiratory distress syndrome (ARDS) patients with coronavirus disease 2019 (COVID-19). We aimed to investigate the effect of high-flow nasal cannula (HFNC) failure before mechanical ventilation on clinical outcomes in mechanically ventilated patients with COVID-19.
Methods: This retrospective cohort study included mechanically ventilated patients who were diagnosed with COVID-19 and admitted to the intensive care unit (ICU) between February 2020 and December 2021 at Asan Medical Center. The patients were divided into HFNC failure (HFNC-F) and mechanical ventilation (MV) groups according to the use of HFNC before MV. The primary outcome of this study was to compare the worst values of ventilator parameters from day 1 to day 3 after mechanical ventilation between the two groups.
Results: Overall, 158 mechanically ventilated patients with COVID-19 were included in this study: 107 patients (67.7%) in the HFNC-F group and 51 (32.3%) in the MV group. The two groups had similar profiles of ventilator parameter from day 1 to day 3 after mechanical ventilation, except of dynamic compliance on day 3 (28.38 mL/cmH2O in MV vs. 30.67 mL/H2O in HFNC-F, p = 0.032). In addition, the HFNC-F group (5.6%) had a lower rate of ECMO at 28 days than the MV group (17.6%), even after adjustment (adjusted hazard ratio, 0.30; 95% confidence interval, 0.11-0.83; p = 0.045).
Conclusions: Among mechanically ventilated COVID-19 patients, HFNC failure before mechanical ventilation was not associated with deterioration of respiratory failure.
Keywords: COVID-19; Critical care outcomes; Mechanical ventilators; Noninvasive ventilation; Respiratory distress syndrome.