High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure

Purpose: Whether the use of high-flow nasal oxygen in adult patients with COVID-19 associated acute respiratory failure improves clinically relevant outcomes remains unclear. We thus sought to assess the effect of high-flow nasal oxygen on ventilator-free days, compared to early initiation of invasi...

Descripción completa

Detalles Bibliográficos
Autores: Mellado Artigas, Ricard, Ferreyro, Bruno Leonel, Angriman, Federico, Hernández Sanz, María L., Arruti, Egoitz, Torres Martí, Antoni, Villar, Jesús, Brochard, Laurent, Ferrando, Carlos, COVID-19 Spanish ICU Network
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/185989
Acceso en línea:https://hdl.handle.net/2445/185989
Access Level:acceso abierto
Palabra clave:COVID-19
Malalties de l'aparell respiratori
Oxigenoteràpia
Respiració artificial
Respiratory diseases
Oxygen therapy
Artificial respiration
id ES_7baf7df3c2fd8d4905e575c1bb273e64
oai_identifier_str oai:recercat.cat:2445/185989
network_acronym_str ES
network_name_str España
repository_id_str
spelling High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failureMellado Artigas, RicardFerreyro, Bruno LeonelAngriman, FedericoHernández Sanz, María L.Arruti, EgoitzTorres Martí, AntoniVillar, JesúsBrochard, LaurentFerrando, CarlosCOVID-19 Spanish ICU NetworkCOVID-19Malalties de l'aparell respiratoriOxigenoteràpiaRespiració artificialCOVID-19Respiratory diseasesOxygen therapyArtificial respirationPurpose: Whether the use of high-flow nasal oxygen in adult patients with COVID-19 associated acute respiratory failure improves clinically relevant outcomes remains unclear. We thus sought to assess the effect of high-flow nasal oxygen on ventilator-free days, compared to early initiation of invasive mechanical ventilation, on adult patients with COVID-19. Methods: We conducted a multicentre cohort study using a prospectively collected database of patients with COVID-19 associated acute respiratory failure admitted to 36 Spanish and Andorran intensive care units (ICUs). Main exposure was the use of high-flow nasal oxygen (conservative group), while early invasive mechanical ventilation (within the first day of ICU admission; early intubation group) served as the comparator. The primary outcome was ventilator-free days at 28 days. ICU length of stay and all-cause in-hospital mortality served as secondary outcomes. We used propensity score matching to adjust for measured confounding. Results: Out of 468 eligible patients, a total of 122 matched patients were included in the present analysis (61 for each group). When compared to early intubation, the use of high-flow nasal oxygen was associated with an increase in ventilator-free days (mean difference: 8.0 days; 95% confidence interval (CI): 4.4 to 11.7 days) and a reduction in ICU length of stay (mean difference: - 8.2 days; 95% CI - 12.7 to - 3.6 days). No difference was observed in all-cause in-hospital mortality between groups (odds ratio: 0.64; 95% CI: 0.25 to 1.64). Conclusions: The use of high-flow nasal oxygen upon ICU admission in adult patients with COVID-19 related acute hypoxemic respiratory failure may lead to an increase in ventilator-free days and a reduction in ICU length of stay, when compared to early initiation of invasive mechanical ventilation. Future studies should confirm our findings.BioMed Central2022202220212022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion10 p.application/pdfhttps://hdl.handle.net/2445/185989Articles publicats en revistes (Medicina)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1186/s13054-021-03469-wCritical Care, 2021, vol. 25, num. 1, p. 58https://doi.org/10.1186/s13054-021-03469-wcc-by (c) Mellado Artigas, Ricard et al., 2021https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1859892026-05-29T05:05:01Z
dc.title.none.fl_str_mv High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure
title High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure
spellingShingle High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure
Mellado Artigas, Ricard
COVID-19
Malalties de l'aparell respiratori
Oxigenoteràpia
Respiració artificial
COVID-19
Respiratory diseases
Oxygen therapy
Artificial respiration
title_short High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure
title_full High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure
title_fullStr High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure
title_full_unstemmed High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure
title_sort High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure
dc.creator.none.fl_str_mv Mellado Artigas, Ricard
Ferreyro, Bruno Leonel
Angriman, Federico
Hernández Sanz, María L.
Arruti, Egoitz
Torres Martí, Antoni
Villar, Jesús
Brochard, Laurent
Ferrando, Carlos
COVID-19 Spanish ICU Network
author Mellado Artigas, Ricard
author_facet Mellado Artigas, Ricard
Ferreyro, Bruno Leonel
Angriman, Federico
Hernández Sanz, María L.
Arruti, Egoitz
Torres Martí, Antoni
Villar, Jesús
Brochard, Laurent
Ferrando, Carlos
COVID-19 Spanish ICU Network
author_role author
author2 Ferreyro, Bruno Leonel
Angriman, Federico
Hernández Sanz, María L.
Arruti, Egoitz
Torres Martí, Antoni
Villar, Jesús
Brochard, Laurent
Ferrando, Carlos
COVID-19 Spanish ICU Network
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv COVID-19
Malalties de l'aparell respiratori
Oxigenoteràpia
Respiració artificial
COVID-19
Respiratory diseases
Oxygen therapy
Artificial respiration
topic COVID-19
Malalties de l'aparell respiratori
Oxigenoteràpia
Respiració artificial
COVID-19
Respiratory diseases
Oxygen therapy
Artificial respiration
description Purpose: Whether the use of high-flow nasal oxygen in adult patients with COVID-19 associated acute respiratory failure improves clinically relevant outcomes remains unclear. We thus sought to assess the effect of high-flow nasal oxygen on ventilator-free days, compared to early initiation of invasive mechanical ventilation, on adult patients with COVID-19. Methods: We conducted a multicentre cohort study using a prospectively collected database of patients with COVID-19 associated acute respiratory failure admitted to 36 Spanish and Andorran intensive care units (ICUs). Main exposure was the use of high-flow nasal oxygen (conservative group), while early invasive mechanical ventilation (within the first day of ICU admission; early intubation group) served as the comparator. The primary outcome was ventilator-free days at 28 days. ICU length of stay and all-cause in-hospital mortality served as secondary outcomes. We used propensity score matching to adjust for measured confounding. Results: Out of 468 eligible patients, a total of 122 matched patients were included in the present analysis (61 for each group). When compared to early intubation, the use of high-flow nasal oxygen was associated with an increase in ventilator-free days (mean difference: 8.0 days; 95% confidence interval (CI): 4.4 to 11.7 days) and a reduction in ICU length of stay (mean difference: - 8.2 days; 95% CI - 12.7 to - 3.6 days). No difference was observed in all-cause in-hospital mortality between groups (odds ratio: 0.64; 95% CI: 0.25 to 1.64). Conclusions: The use of high-flow nasal oxygen upon ICU admission in adult patients with COVID-19 related acute hypoxemic respiratory failure may lead to an increase in ventilator-free days and a reduction in ICU length of stay, when compared to early initiation of invasive mechanical ventilation. Future studies should confirm our findings.
publishDate 2021
dc.date.none.fl_str_mv 2021
2022
2022
2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/185989
url https://hdl.handle.net/2445/185989
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1186/s13054-021-03469-w
Critical Care, 2021, vol. 25, num. 1, p. 58
https://doi.org/10.1186/s13054-021-03469-w
dc.rights.none.fl_str_mv cc-by (c) Mellado Artigas, Ricard et al., 2021
https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Mellado Artigas, Ricard et al., 2021
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 10 p.
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869411533355745280
score 15,808905

Similares en LA Referencia