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High-flow nasal cannula for Acute Respiratory Distress Syndrome (ARDS) due to COVID-19.
Panadero, Carolina; Abad-Fernández, Araceli; Rio-Ramirez, Mª Teresa; Acosta Gutierrez, Carmen Maria; Calderon-Alcala, Mariara; Lopez-Riolobos, Cristina; Matesanz-Lopez, Cristina; Garcia-Prieto, Fernando; Diaz-Garcia, Jose Maria; Raboso-Moreno, Beatriz; Vasquez-Gambasica, Zully; Andres-Ruzafa, Pilar; Garcia-Satue, Jose Luis; Calero-Pardo, Sara; Sagastizabal, Belen; Bautista, Diego; Campos, Alfonso; González, Marina; Grande, Luis; Jimenez Fernandez, Marta; Santiago-Ruiz, Jose L; Caravaca Perez, Pedro; Alcaraz, Andres Jose.
Affiliation
  • Panadero C; Pulmonology Department, Hospital Universitario de Getafe, Madrid.
  • Abad-Fernández A; Pulmonology Department, Hospital Universitario de Getafe, Madrid.
  • Rio-Ramirez MT; Pulmonology Department, Hospital Universitario de Getafe, Madrid.
  • Acosta Gutierrez CM; Pulmonology Department, Hospital Universitario de Getafe, Madrid.
  • Calderon-Alcala M; Pulmonology Department, Hospital Universitario de Getafe, Madrid.
  • Lopez-Riolobos C; Pulmonology Department, Hospital Universitario de Getafe, Madrid.
  • Matesanz-Lopez C; Pulmonology Department, Hospital Universitario de Getafe, Madrid.
  • Garcia-Prieto F; Pulmonology Department, Hospital Universitario de Getafe, Madrid.
  • Diaz-Garcia JM; Pulmonology Department, Hospital Universitario de Getafe, Madrid.
  • Raboso-Moreno B; Pulmonology Department, Hospital Universitario de Getafe, Madrid.
  • Vasquez-Gambasica Z; Pulmonology Department, Hospital Universitario de Getafe, Madrid.
  • Andres-Ruzafa P; Pulmonology Department, Hospital Universitario de Getafe, Madrid.
  • Garcia-Satue JL; Pulmonology Department, Hospital Universitario de Getafe, Madrid.
  • Calero-Pardo S; Pulmonology Department, Hospital Universitario de Getafe, Madrid.
  • Sagastizabal B; Department of Pediatrics, Hospital Universitario de Getafe, Madrid.
  • Bautista D; Department of Pediatrics, Hospital Universitario de Getafe, Madrid.
  • Campos A; Department of Pediatrics, Hospital Universitario de Getafe, Madrid.
  • González M; Department of Pediatrics, Hospital Universitario de Getafe, Madrid.
  • Grande L; Department of Pediatrics, Hospital Universitario de Getafe, Madrid.
  • Jimenez Fernandez M; Thoracic Surgery Department, Hospital Universitario de Getafe, Madrid.
  • Santiago-Ruiz JL; Cardiology Department, Hospital Universitario de Getafe, Madrid.
  • Caravaca Perez P; Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), CIBERCV, Madrid, Spain.
  • Alcaraz AJ; Department of Pediatrics, Hospital Universitario de Getafe, Madrid.
Multidiscip Respir Med ; 15(1): 693, 2020 Jan 28.
Article in En | MEDLINE | ID: mdl-32983456
ABSTRACT

INTRODUCTION:

High-flow nasal cannula oxygen therapy (HFNC) has been shown to be a useful therapy in the treatment of patients with Acute Respiratory Distress Syndrome (ARDS), but its efficacy is still unknown in patients with COVID-19. Our objective is to describe its utility as therapy for the treatment of ARDS caused by SARS-CoV-2.

METHODS:

A retrospective, observational study was performed at a single centre, evaluating patients with ARDS secondary to COVID-19 treated with HFNC. The main outcome was the intubation rate at day 30, which defined failure of therapy. We also analysed the role of the ROX index to predict the need for intubation.

RESULTS:

In the study period, 196 patients with bilateral pneumonia were admitted to our pulmonology unit, 40 of whom were treated with HFNC due to the presence of ARDS. The intubation rate at day 30 was 52.5%, and overall mortality was 22.5%. After initiating HFNC, the SpO2/FiO2 ratio was significantly better in the group that did not require intubation (113.4±6.6 vs 93.7±6.7, p=0.020), as was the ROX index (5.0±1.6 vs 4.0±1.0, p=0.018). A ROX index less than 4.94 measured 2 to 6 h after the start of therapy was associated with increased risk of intubation (HR 4.03 [95% CI 1.18 - 13.7]; p=0.026).

CONCLUSION:

High-flow therapy is a useful treatment in ARDS in order to avoid intubation or as a bridge therapy, and no increased mortality was observed secondary to the delay in intubation. After initiating HFNC, a ROX index below 4.94 predicts the need for intubation.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Observational_studies / Prognostic_studies Language: En Journal: Multidiscip Respir Med Year: 2020 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Observational_studies / Prognostic_studies Language: En Journal: Multidiscip Respir Med Year: 2020 Document type: Article