1. High-flow nasal cannula oxygen therapy in hypoxic patients with COVID-19 pneumonia: A retrospective cohort study confirming the utility of respiratory rate index
- Author
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Toru Kinouchi, Yuichiro Takeshita, Jiro Terada, Yuji Tada, Yu Shionoya, Kenji Tsushima, Ken Koshikawa, Yuri Isaka, Hiroshi Tajima, Yasutaka Hirasawa, and Taku Kinoshita
- Subjects
Pulmonary and Respiratory Medicine ,Respiratory rate ,medicine.medical_treatment ,ARF, acute respiratory failure ,BMI, body mass index ,RR, respiratory rate ,Respiratory failure ,medicine.disease_cause ,Respiratory Rate ,FiO2, fraction of inspired oxygen ,Oxygen therapy ,Fraction of inspired oxygen ,medicine ,Cannula ,Humans ,Oxygen saturation (medicine) ,COT, conventional oxygen therapy ,COVID-19, coronavirus disease 2019 ,Retrospective Studies ,Univariate analysis ,Noninvasive Ventilation ,business.industry ,SPO2, oxygen saturation ,SARS-CoV-2 ,Oxygen Inhalation Therapy ,COVID-19 ,Retrospective cohort study ,Pneumonia ,HR, hazard ratio ,ICU, intensive care unit ,OR, odds ratio ,Oxygen ,Oxygen Saturation ,Anesthesia ,High-flow nasal cannula ,HFNC, high-flow nasal cannula ,Original Article ,ROX, respiratory rate-oxygenation ,business ,SD, standard deviation ,Respiratory Insufficiency ,Nasal cannula - Abstract
Background Although high-flow nasal cannula (HFNC) oxygen treatment has been frequently used in coronavirus disease 2019 (COVID-19) patients with acute respiratory failure after the 3rd wave of the pandemic in Japan, the usefulness of the indicators of ventilator avoidance, including respiratory rate-oxygenation (ROX) index and other parameters, namely oxygen saturation/fraction of inspired oxygen ratio and respiratory rate (RR), remain unclear. Methods Between January and May 2021, our institution treated 189 COVID-19 patients with respiratory failure requiring oxygen, among which 39 patients requiring HFNC treatment were retrospectively analyzed. The group that switched from HFNC treatment to conventional oxygen therapy (COT) was defined as the HFNC success group, and the group that switched from HFNC treatment to a ventilator was defined as the HFNC failure group. We followed the patients' oxygenation parameters for a maximum of 30 days. Results HFNC treatment success occurred in 24 of 39 patients (62%) treated with HFNC therapy. Compared with the HFNC failure group, the HFNC success group had a significantly higher degree of RR improvement in the univariate analysis. Logistic regression analysis of HFNC treatment success adjusting for age, respiratory improvement, and a ROX index ≥5.55 demonstrated that an improved RR was associated with HFNC treatment success. The total COT duration was significantly shorter in the HFNC success group than in the HFNC failure group. Conclusions HFNC treatment can be useful for ventilator avoidance and allow the quick withdrawal of oxygen administration. RR improvement may be a convenient, useful, and simple indicator of HFNC treatment success.
- Published
- 2021