Prognosis of mechanically ventilated patients with COVID-19 after failure of high-flow nasal cannula: a retrospective cohort study

被引:0
作者
Hyun, Dong-gon [1 ]
Lee, Su Yeon [1 ]
Ahn, Jee Hwan [1 ]
Hong, Sang-Bum [1 ]
Lim, Chae-Man [1 ]
Koh, Younsuck [1 ]
Huh, Jin Won [1 ]
机构
[1] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Pulm & Crit Care Med, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea
关键词
COVID-19; Noninvasive ventilation; Respiratory distress syndrome; Mechanical ventilators; Critical care outcomes; RESPIRATORY-FAILURE; OXYGEN-THERAPY;
D O I
10.1186/s12931-024-02671-y
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
BackgroundThere is an argument whether the delayed intubation aggravate the respiratory failure in Acute respiratory distress syndrome (ARDS) patients with coronavirus disease 2019 (COVID-19). We aimed to investigate the effect of high-flow nasal cannula (HFNC) failure before mechanical ventilation on clinical outcomes in mechanically ventilated patients with COVID-19.MethodsThis retrospective cohort study included mechanically ventilated patients who were diagnosed with COVID-19 and admitted to the intensive care unit (ICU) between February 2020 and December 2021 at Asan Medical Center. The patients were divided into HFNC failure (HFNC-F) and mechanical ventilation (MV) groups according to the use of HFNC before MV. The primary outcome of this study was to compare the worst values of ventilator parameters from day 1 to day 3 after mechanical ventilation between the two groups.ResultsOverall, 158 mechanically ventilated patients with COVID-19 were included in this study: 107 patients (67.7%) in the HFNC-F group and 51 (32.3%) in the MV group. The two groups had similar profiles of ventilator parameter from day 1 to day 3 after mechanical ventilation, except of dynamic compliance on day 3 (28.38 mL/cmH2O in MV vs. 30.67 mL/H2O in HFNC-F, p = 0.032). In addition, the HFNC-F group (5.6%) had a lower rate of ECMO at 28 days than the MV group (17.6%), even after adjustment (adjusted hazard ratio, 0.30; 95% confidence interval, 0.11-0.83; p = 0.045).ConclusionsAmong mechanically ventilated COVID-19 patients, HFNC failure before mechanical ventilation was not associated with deterioration of respiratory failure.
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