High-flow nasal oxygen therapy in the treatment of acute respiratory failure in severe COVID-19 pneumonia: a prospective observational study

Celejewska‐Wójcik, Natalia; Polok, Kamil; Górka, Karolina; Stachura, Tomasz; Kania, Aleksander; Nadziakiewicz, Paweł; Lichołai, Sabina; Krawczyk, Jacek B.; Wójcik, Krzysztof; Sładek, Krzysztof

doi:10.20452/pamw.16015

Cited by 11 publications

(37 citation statements)

References 18 publications

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“…Even though in our cohort male patients were predominant, sex turned out not to be a factor determining mortality or effectiveness of HFNO, similar to the research by Calligaro et al [24]. The most predominant chronic diseases were cardiovascular disease, obesity, malignancies, diabetes, chronic renal disease, chronic respiratory disease [1,17,19,20,23,[25][26][27][28], which is consistent with our observations (Table 2). Qualitative variables presented as counts and frequencies, quantitative variables presented as mean (SD), median (interquartile range).…”

Section: Discussionsupporting

confidence: 92%

“…Our study shows that effectiveness of HFNO (understood as no requirement to escalate the therapy for respiratory failure, and discharge from hospital) in patients with severe respiratory failure is 46% (Table 7), which is in line with data in the literature-from 34 to 62% depending on the severity of ARDS [19,23,24,[34][35][36]. In the group studied, all patients were primarily treated with HFNO.…”

Section: Discussionsupporting

confidence: 88%

“…According to the literature, the intubation rate in patients treated with HFNO ranges from 31 to 66% [19,24,[34][35][36]; in our study group it reached 30.5% (61/200). Our relatively low rate of intubation is related to using NIV in some patients.…”

Section: Discussionmentioning

confidence: 48%

“…Patients in the critical condition make up approximately 3-5% of all patients with COVID-19. In this group, the fatality rate reaches 50%, whereas it does not usually exceed 5-10% among COVID-19 patients as a whole [17][18][19][20][21]. In our research group, mortality reached 40.5% (Table 7).…”

Section: Discussionmentioning

confidence: 52%

“…In our research group, mortality reached 40.5% (Table 7). Patients over 60-70 years old and with underlying diseases have higher fatality rates than younger patients without comorbidities [17,[19][20][21]. Sex is not relevant in terms of morbidity, although some researchers showed male predominance among patients admitted to intensive care units and HFNO failure [22,23].…”

Section: Discussionmentioning

confidence: 99%

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When Conventional Oxygen Therapy Fails—The Effectiveness of High-Flow Nasal Oxygen Therapy in Patients with Respiratory Failure in the Course of COVID-19

Rorat

Szymański

Karczewski

et al. 2021

JCM

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High-flow nasal oxygen (HFNO) is recommended as a first-line treatment in patients with acute hypoxemic respiratory failure due to COVID-19. We assessed the effectiveness of HFNO and predictors of failure and death. The medical records of 200 consecutive adult patients treated with HFNO were analysed. Ninety-two patients (46%) were successfully cured, 52 (26%) required noninvasive ventilation, and 61 (30.5%) received intubation. Overall mortality was 40.5%. Risk factors of HFNO ineffectiveness were: SpO2 ≤ 90% with conventional oxygen therapy (HR 0.32, 95% CI 0.19–0.53, p < 0.001), SpO2 ≤ 74% without oxygen therapy (HR 0.44, 95% CI 0.27–0.71, p < 0.001), an age ≥ 60, comorbidities, biomarkers (C-reactive protein, procalcitonin, creatinine, lactate dehydrogenase), duration of symptoms before admission to hospital ≤ 9 days, start of treatment with HFNO ≤ 4 days. The multivariate logistic regression models (age ≥ 60, comorbidities, C-reactive protein concentration and SpO2 with oxygen therapy) revealed a high predictive value of death and HFNO failure (AUC 0.851, sensitivity 0.780, specificity 0.802; AUC 0.800, sensitivity 0.776, specificity 0.739, respectively). HFNO is a safe method for treating acute hypoxemic respiratory failure, with effectiveness reaching nearly 50%. Low values of SpO2 without and during oxygen therapy seem to be good diagnostic tools for predicting death and HFNO failure.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

When Conventional Oxygen Therapy Fails—The Effectiveness of High-Flow Nasal Oxygen Therapy in Patients with Respiratory Failure in the Course of COVID-19

Rorat

Szymański

Karczewski

et al. 2021

JCM

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Failure Nasal High-Flow Oxygen in High-Risk Infections

Chawla¹,

Abrol

2023

Noninvasive Mechanical Ventilation in High Risk Infections, Mass Casualty and Pandemics

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Association between undiagnosed obstructive sleep apnea and severe course of COVID-19: a prospective observational study

et al. 2023

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Purpose Obstructive sleep apnea (OSA) is associated with many long-term health consequences. We hypothesized that previously unrecognized and untreated OSA may be associated with more severe respiratory failure in hospitalized patients with COVID-19. Methods Patients hospitalized in the Pulmonology Department with confirmed COVID-19, University Hospital in Kraków, Poland, between September 2020 and April 2021 were enrolled. OSA screening questionnaires including Epworth Sleepiness Scale (ESS), STOP-BANG, Berlin questionaire (BQ), OSA-50, and No-SAS were completed. Polygraphy was performed after > 24 h without requirement for supplemental oxygen. Results Of 125 patients with median age of 61.0 years, 71% of whom were male. OSA was diagnosed in 103 patients (82%) and was categorized as mild, moderate, and severe in 41 (33%), 30 (24%), and 32 (26%), respectively. Advanced respiratory support was introduced in 85 patients (68%), and 8 (7%) patients eventually required intubation. Multivariable analysis revealed that increased risk of requirement for advanced respiratory support was associated with higher respiratory event index (OR 1.03, 95%CI 1.00 to 1.07), oxygen desaturation index (OR 1.05, 95%CI 1.02 to 1.10), and hypoxic burden (1.02 95% CI 1.00 to 1.03) and lower minimal SpO2 (OR 0.89, 95%CI 0.81 to 0.98), but not with results of OSA screening tools like BQ score (OR 0.66, 95%CI 0.38 to 1.16), STOP-BANG score (OR 0.73, 95%CI 0.51 to 1.01), NoSAS score (OR 1.01, 95%CI 0.87 to 1.18), or OSA50 score (OR 0.84, 95%CI 0.70 to 1.01). Conclusion Previously undiagnosed OSA was common among hospitalized patients who survived the acute phase of COVID-19. The degree of OSA was associated with the severity of respiratory failure.

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High-flow nasal oxygen therapy in the treatment of acute respiratory failure in severe COVID-19 pneumonia: a prospective observational study

Cited by 11 publications

References 18 publications

When Conventional Oxygen Therapy Fails—The Effectiveness of High-Flow Nasal Oxygen Therapy in Patients with Respiratory Failure in the Course of COVID-19

When Conventional Oxygen Therapy Fails—The Effectiveness of High-Flow Nasal Oxygen Therapy in Patients with Respiratory Failure in the Course of COVID-19

Failure Nasal High-Flow Oxygen in High-Risk Infections

Association between undiagnosed obstructive sleep apnea and severe course of COVID-19: a prospective observational study

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