J Med Virol. 2021 Nov 9. doi: 10.1002/jmv.27442. Online ahead of print.
ABSTRACT
BACKGROUND: Five percent of patients infected with SARS-CoV-2 requires advanced respiratory support. The high flow nasal cannula oxygenotherapy (HFNCO) appears to be effective and safe to reduce the need for mechanical ventilation. However, the factors associated to HFNCO failure as well as the outcomes of patients receiving this non-invasive respiratory strategy remain unclear. Thus, we performed this study to determine factors leading to intubation of SARS-CoV-2 patients treated with HFNCO and patients' outcomes.
METHODS: We retrospectively analyzed the medical charts of patients admitted in our ICU center for acute respiratory failure due to SARS-CoV-2 infection and who initially benefited from HFNCO, between September 1st , 2020 and March 1st , 2021. We included all adults patients who received HFNCO and compared two groups: those treated with HFNCO alone and those who failed HFNCO. Patients treated with HFNCO and secondarily limited to the use of mechanical ventilation were excluded from the analysis.
RESULTS: Seventy-two patients were included, 33 were treated with HFNCO alone and 36 failed HFNCO. We found more patients with shock in the HFNCO failure group (p = 0.001). The mean IGSII score was higher in the HFNCO failure group (p < 0.001). The minimum PaO2 / FiO2 was lower in the HFNCO failure group (p = 0.024). The length of stay in ICU was higher in HFNCO failure group (p < 0.001). The mean duration of HFNCO before intubation was 1.77 days. Six-week mortality was higher in the HFNCO failure group (p = 0.034). Ten patients had a complication during intubation.
CONCLUSIONS: The HFNCO leads to reduce the intubation rate, the length of stay in ICU and the mortality. Determining the factors associated with HFNCO failure is important in order to avoid complications following late intubation. This article is protected by copyright. All rights reserved.
PMID:34755373 | DOI:10.1002/jmv.27442