High-flow nasal oxygen (HFNO) for patients with Covid-19 outside intensive care units - 19/10/21
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Abstract |
Introduction |
High-flow nasal oxygen (HFNO) has traditionally only been used in intensive care units (ICU) especially in acute respiratory distress syndrome (ARDS).
Methods |
We studied the use of HFNO at Södersjukhuset, Stockholm, in patients with moderate to severe ARDS related to Covid-19 as well as its benefits both for patients and to offload the ICU. The patients were observed with frequent controls to assess the need of ICU in case of deterioration.
Results |
We studied 41 patients with HFNO treatment either as primarily treatment (Step-Up) or after stabilizing in the ICU (Step-Down). The average duration for treatment with HFNO was 5.6 days. Of these patients 55% were discharged home or to geriatric rehabilitation and 10% avoided ICU completely. The usage of HFNO saved in total 229 days in the ICU. Mortality was higher among elderly patients, and patients with comorbidities (mainly hypertension and obesity).
Discussion and conclusion |
HFNO treatment is feasible and efficient for patients with Covid-19, saving resources in the ICU and offering additional advantages as waken proning and fewer complications compared to traditional ICU care. It requires however frequent controls as deterioration is recurrent.
Le texte complet de cet article est disponible en PDF.Highlights |
• | HFNO during Covid-19 pandemic is an applicable and effective therapy that can offload ICU when safely used in medical wards. |
• | Frequent control of vital signs are needed because of risk for deterioration. |
• | Step-Down treatment with HFNO has probably further benefits. |
• | There is a need of randomised trials where HFNO treatment is compared in- and outside the ICU. |
Keywords : High-flow nasal oxygen, Covid-19, ICU, ARDS
Plan
Vol 187
Article 106554- octobre 2021 Retour au numéro
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