Noninvasive Ventilation and High-flow Nasal Cannula in Patients with Acute Hypoxemic Respiratory Failure by Covid-19: A Retrospective Study of the Feasibility, Safety and Outcomes

Overview

Journal Respir Physiol Neurobiol

Specialty Pulmonary Medicine

Date 2022 Jan 13

PMID 35026479

Authors

Wesla Neves da Silva Costa

Juliana Padovezi Miguel

Fabiana Dos Santos Prado

Liz Helena Santos de Mello Lula

Gustavo Adolpho Junqueira Amarante

Renato Fraga Righetti

Wellington Pereira Yamaguti

Affiliations

Soon will be listed here.

Abstract

Background: Noninvasive ventilation (NIV) and High-flow nasal cannula (HFNC) are the main forms of treatment for acute respiratory failure. This study aimed to evaluate the effect, safety, and applicability of the NIV and HFNC in patients with acute hypoxemic respiratory failure (AHRF) caused by COVID-19.

Methods: In this retrospective study, we monitored the effect of NIV and HFNC on the SpO and respiratory rate before, during, and after treatment, length of stay, rates of endotracheal intubation, and mortality in patients with AHRF caused by COVID-19. Additionally, data regarding RT-PCR from physiotherapists who were directly involved in assisting COVID-19 patients and non-COVID-19.

Results: 62.2 % of patients were treated with HFNC. ROX index increased during and after NIV and HFNC treatment (P < 0.05). SpO increased during NIV treatment (P < 0.05), but was not maintained after treatment (P = 0.17). In addition, there was no difference in the respiratory rate during or after the NIV (P = 0.95) or HFNC (P = 0.60) treatment. The mortality rate was 35.7 % for NIV vs 21.4 % for HFNC (P = 0.45), while the total endotracheal intubation rate was 57.1 % for NIV vs 69.6 % for HFNC (P = 0.49). Two adverse events occurred during treatment with NIV and eight occurred during treatment with HFNC. There was no difference in the physiotherapists who tested positive for SARS-COV-2 directly involved in assisting COVID-19 patients and non-COVID-19 ones (P = 0.81).

Conclusion: The application of NIV and HFNC in the critical care unit is feasible and associated with favorable outcomes. In addition, there was no increase in the infection of physiotherapists with SARS-CoV-2.

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