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Deprecated: Implicit conversion from float 251.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Anaesthesiol+Intensive+Ther 2020 ; 52 (5): 373-376 Nephropedia Template TP
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Clinical outcomes of high-flow nasal cannula in COVID-19 associated postextubation respiratory failure A single-centre case series #MMPMID33242934
Simioli F; Annunziata A; Langella G; Polistina GE; Martino M; Fiorentino G
Anaesthesiol Intensive Ther 2020[]; 52 (5): 373-376 PMID33242934show ga
INTRODUCTION: A high-flow nasal cannula (HFNC) is an alternative device for oxygena-tion, which improves gas exchange and reduces the work of breathing. Postextubation respiratory failure causes increased morbidity and mortality. HFNC has been widely employed during the COVID-19 pandemic. The purpose of this paper is to report a single-centre experience on the effectiveness and safety of HFNC in weaning COVID-19 patients. MATERIAL AND METHODS: Nine patients showed severe acute respiratory failure and interstitial pneumonia due to SARS-CoV-2. After mechanical ventilation (5 Helmet CPAP, 4 invasive mechanical ventilation), they were de-escalated to HFNC. Settings were: 34-37 degrees C, flow from 50 to 60 L min-1. FiO2 was set to achieve appropriate SpO2. RESULTS: Nine patients (4 females; age 63 +/- 13.27 years; BMI 27.2 +/- 4.27) showed a baseline PaO2/FiO2 of 109 +/- 45 mm Hg. After a long course of ventilation all patients improved (PaO2/FiO2 336 +/- 72 mm Hg). Immediately after initiation of HFNC (2 hours), PaO2/FiO2 was 254 +/- 69.3 mm Hg. Mean ROX index at two hours was 11.17 (range: 7.38-14.4). It was consistent with low risk of HFNC failure. No difference was observed on lactate. After 48 hours of HFNC oxygen therapy (day 3), mean PaO2/FiO2 increased to 396 +/- 83.5 mm Hg. All patients recovered from respiratory failure after 7 +/- 4.1 days. CONCLUSIONS: HFNC might be helpful in weaning COVID-19 respiratory failure. Effectiveness and comfort should be assessed between 2 and 48 hours. Clinical outcomes, oxygenation, and ROX index should be considered, to rule out the need for intubation. Further evidence is required for firm conclusions.