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High-Flow Nasal Cannula Therapy in Patients With COVID-19: Predictive Response Factors.
Raboni, Sonia M; Neves, Valeria C; Silva, Rauce M; Breda, Giovanni L; Ceregato, Andressa Cl; Broza, Thayza P; de Oliveira, Glauber; Melo-Diaz, Lucelia L; Braga, Claudia B; Carraro, César F; Arroyo, Natalia C; Bardy, Rafael F; Devetak, Gisele F; Ozawa, Caroline M; Graf, Maria Esther; Dias, Vitor L; Ducroquet, Marcelo A; Nunes, Daniella P; Sokoloski, Caroline S; Petterle, Ricardo R.
  • Raboni SM; Infectious Diseases Division, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil. sraboni@ufpr.br.
  • Neves VC; Rehabilitation in Physical Therapy Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Silva RM; Rehabilitation in Physical Therapy Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Breda GL; Infectious Diseases Division, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Ceregato AC; Rehabilitation in Physical Therapy Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Broza TP; Rehabilitation in Physical Therapy Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • de Oliveira G; Rehabilitation in Physical Therapy Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Melo-Diaz LL; Rehabilitation in Physical Therapy Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Braga CB; Rehabilitation in Physical Therapy Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Carraro CF; Rehabilitation in Physical Therapy Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Arroyo NC; Rehabilitation in Physical Therapy Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Bardy RF; Rehabilitation in Physical Therapy Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Devetak GF; Rehabilitation in Physical Therapy Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Ozawa CM; Rehabilitation in Physical Therapy Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Graf ME; Infectious Diseases Division, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Dias VL; Cardio-Pneumology Division, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Ducroquet MA; Infectious Diseases Division, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Nunes DP; Cardio-Pneumology Division, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Sokoloski CS; Cardio-Pneumology Division, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
  • Petterle RR; Department of Integrative Medicine, Universidade Federal do Paraná, Curitiba, Brazil.
Respir Care ; 67(11): 1443-1451, 2022 11.
Статья в английский | MEDLINE | ID: covidwho-1988239
ABSTRACT

BACKGROUND:

COVID-19 pneumonia has been responsible for many ICU patients' admissions with hypoxemic respiratory failure, and oxygen therapy is one of the pillars of its treatment. The current pandemic scenario has limited the availability of ICU beds and access to invasive ventilation equipment. High-flow nasal cannula (HFNC) can reduce the need for orotracheal intubation compared with conventional oxygen therapy, providing better results than noninvasive respiratory support. However, HFNC use has been controversial due to concerns about the benefits and risks of aerosol dispersion. In this context, we evaluated the performance of the HFNC therapy in patients with COVID-19 and investigated factors that can predict favorable responses.

METHODS:

A prospective observational study was conducted, which included hospitalized adult subjects with COVID-19 in the respiratory wards who needed oxygen therapy. Clinical and laboratory parameters were collected to compare HFNC therapy use and the outcomes.

RESULTS:

In 6 months, 128 subjects were included and the success rate of HFNC therapy was 53%. Logistic regression analysis showed that the Charlson comorbidity score, need for oxygen flow, [Formula see text], and breathing frequency predicted therapy failure. The mortality rate increased among the non-responders versus the responders (47% vs 3%), 48% of failure occurred in the first 24 h of the HFNC therapy. A ROX (respiratory frequency - oxygenation) index > 4.98 in 6 h and > 4.53 in 24 h predicted success of the HFNC therapy with an area under the curve of 0.7, and a ROX index < 3.47 predicted failure with 88% of specificity.

CONCLUSIONS:

HFNC in the subjects with COVID-19 was associated with reduced mortality and improved oxygenation in the subjects with respiratory distress. Close monitoring of specific parameters defines eligible patients and rapidly identifies those in need of invasive ventilatory support.
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Полный текст: Имеется в наличии Коллекция: Международные базы данных база данных: MEDLINE Основная тема: Cannula / COVID-19 Тип исследования: Экспериментальные исследования / Наблюдательное исследование / Прогностическое исследование Пределы темы: Взрослые / Люди Язык: английский Журнал: Respir Care Год: 2022 Тип: Статья Аффилированная страна: Respcare.09764

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Полный текст: Имеется в наличии Коллекция: Международные базы данных база данных: MEDLINE Основная тема: Cannula / COVID-19 Тип исследования: Экспериментальные исследования / Наблюдательное исследование / Прогностическое исследование Пределы темы: Взрослые / Люди Язык: английский Журнал: Respir Care Год: 2022 Тип: Статья Аффилированная страна: Respcare.09764