Many patients admitted to the intensive care unit (ICU) with hypoxemic respiratory failure due to COVID-19 pneumonia have benefited greatly from oxygen therapy. As the present pandemic unfolds, there has been a reduction in the number of intensive care unit beds and the accessibility of invasive breathing devices. By producing superior outcomes than noninvasive respiratory support, a high-flow nasal cannula (HFNC) can lessen the necessity for orotracheal intubation compared to standard oxygen therapy. However, the use of HFNC has been contentious because of worries about the potential advantages and drawbacks of aerosol dispersion.
Researchers analyzed the efficacy of HFNC treatment for people with COVID-19 and looked for indicators of good outcomes. Adult patients with COVID-19 requiring oxygen therapy in the respiratory wards of a hospital participated in a prospective observational study. The usage of HFNC therapy was compared with the outcomes based on the gathered clinical and laboratory indicators. There were 128 participants over the course of 6 months, with a 53% success rate from HFNC treatment. Treatment failure was predicted by the Charlson comorbidity score, oxygen requirements, Embedded Image, and the rate of breathing. Non-responders had a higher mortality rate than those who responded to HFNC (47% vs. 3%), and nearly half of all HFNC failures happened within the first 24 hours of treatment. The area under the curve of 0.7 for predicting HFNC therapy success was seen for a ROX (respiratory frequency – oxygenation) index of more than 4.98 in 6 h and more than 4.53 in 24 h, whereas a ROX index of less than 3.47 predicted failure with 88% specificity.
There was a correlation between HFNC and better oxygenation and lower mortality in patients with COVID-19 who were experiencing respiratory distress. Patients who meet the criteria for invasive ventilator assistance can be quickly identified through careful monitoring of a few key indicators.
Source: rc.rcjournal.com/content/67/11/1443
