CPAP vs HFNC in treatment of patients with COVID-19 ARDS: A retrospective propensity-matched study.

Autor:	Šitum I; Department of Anesthesiology, Reanimatology, Intensive Medicine and Pain Therapy University Hospital Centre Zagreb., Hrvoić L; Department of Emergency Medicine University Hospital Centre Zagreb., Erceg A; Department of Anesthesiology, Reanimatology, Intensive Medicine and Pain Therapy University Hospital Centre Zagreb., Mandarić A; Department of Anesthesiology, Reanimatology, Intensive Medicine and Pain Therapy University Hospital Centre Zagreb., Karmelić D; Department of Anesthesiology, Reanimatology, Intensive Medicine and Pain Therapy University Hospital Centre Zagreb., Mamić G; Department of Anesthesiology, Reanimatology, Intensive Medicine and Pain Therapy University Hospital Centre Zagreb., Džaja N; Department of Anesthesiology, Reanimatology, Intensive Medicine and Pain Therapy University Hospital Centre Zagreb., Babić A; Department of Anesthesiology, Reanimatology, Intensive Medicine and Pain Therapy University Hospital Centre Zagreb., Mihaljević S; Department of Anesthesiology, Reanimatology, Intensive Medicine and Pain Therapy University Hospital Centre Zagreb., Mažar M; Department of Anesthesiology, Reanimatology, Intensive Medicine and Pain Therapy University Hospital Centre Zagreb., Lovrić D; Department of Cardiology University Hospital Centre Zagreb.
Jazyk:	angličtina
Zdroj:	Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR [Can J Respir Ther] 2024 Oct 31; Vol. 60, pp. 164-172. Date of Electronic Publication: 2024 Oct 31 (Print Publication: 2024).
DOI:	10.29390/001c.125145
Abstrakt:	Background: Previous studies exploring the application of noninvasive ventilation or high-flow nasal cannula in patients with COVID-19-related acute respiratory distress syndrome (ARDS) have yielded conflicting results on whether any method of respiratory support is superior. Our aim is to compare the efficacy and safety of respiratory therapy with high-flow nasal cannula and noninvasive ventilation with continuous positive airway pressure in treatment of COVID-19-related ARDS. Methods: This is a retrospective cohort study based on data from patients who received respiratory support as part of their treatment in the COVID intensive care unit at the University Hospital Centre Zagreb between February 2021 and February 2023. Using propensity score analysis, 42 patients treated with high-flow nasal cannula (HFNC group) were compared to 42 patients treated with noninvasive ventilation with continuous positive airway pressure (CPAP group). Primary outcome was intubation rate. Results: Intubation rate was 71.4% (30/42) in the HFNC group and 40.5% (17/42) in the CPAP group ( p = 0.004). Hazard ratio for intubation was 3.676 (95% confidence interval [CI] 1.480 to 9.232) with the HFNC versus CPAP group. Marginally significant difference in survival between the two groups was observed at 30 days ( p = 0.050) but was statistically significant at 60 days ( p = 0.043). Conclusions: Respiratory support with high-flow nasal cannula and noninvasive ventilation with continuous positive airway pressure yielded significantly different intubation rates in favour of continuous positive airway pressure. The same patients also had better 30-day and 60-day survival post-admission. Competing Interests: The authors have no relevant financial or non-financial interests to disclose. The authors declare no conflict of interest.
Databáze:	MEDLINE
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