High-Flow Nasal Oxygen for Severe Hypoxemia: Oxygenation Response and Outcome in Patients with COVID-19
| Autor: | Giacomo Grasselli, Massimo Antonelli, Chiara Mega, Antonio Pesenti, Roberto Dongilli, Paolo Navalesi, Paola Rucci, Luca S Menga, Laura Pasin, Nicolò Sella, Domenico Luca Grieco, Alessio Dell'Olio, Lara Pisani, V. Marco Ranieri, Giacinto Pizzilli, Tommaso Tonetti, Annalisa Boscolo, Arthur S. Slutsky, Stefano Nava |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male ARDS Coronavirus disease 2019 (COVID-19) medicine.medical_treatment mechanical ventilation Critical Care and Intensive Care Medicine Severe hypoxemia Settore MED/41 - ANESTESIOLOGIA medicine Intubation Humans Hypoxia Aged Mechanical ventilation Respiratory Distress Syndrome business.industry COVID-19 HFNO noninvasive ventilation Respiration Oxygen Inhalation Therapy Patient Acuity Oxygenation Creative commons Middle Aged medicine.disease Treatment Outcome Noninvasive ventilation Female Italy Respiration Artificial Anesthesia Artificial High flow business |
| Popis: | RATIONALE The "Berlin definition" of acute respiratory distress syndrome (ARDS) does not allow inclusion of patients receiving high-flow nasal oxygen (HFNO). However, several articles proposed that criteria for defining ARDS should be broadened to allow inclusion of patients receiving HFNO. OBJECTIVE To compare the proportion of patients fulfilling ARDS criteria during HFNO and soon after intubation, and 28-day mortality between patients treated exclusively with HFNO and patients transitioned from HFNO to IMV. METHODS From previously published studies we analyzed COVID-19 patients who had PaO2/FiO2 ≤300 while treated with HFNO ≥40 L/min, or NIV with PEEP ≥5 cmH2O (comparator). In patients transitioned from HFNO/NIV to invasive mechanical ventilation (IMV), we compared ARDS severity during HFNO/NIV and soon after IMV. We compared 28-day mortality in patients treated exclusively with HFNO/NIV vs. transitioned to IMV. MEASUREMENTS AND MAIN RESULTS We analyzed 184 and 131 patients receiving HFNO or NIV, respectively. 112 HFNO, and 69 NIV patients transitioned to IMV. 104 (92.9%) HFNO patients and 66 (95.7%) NIV patients continued to have PaO2/FiO2 ≤300 under IMV. 28-day mortality in patients who remained on HFNO was 4.2% (3/72) while in patients transitioned from HFNO to IMV it was 28.6% (32/112) (p |
| Databáze: | OpenAIRE |
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