Please use this identifier to cite or link to this item:
http://hdl.handle.net/2445/185989
Title: | High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure |
Author: | 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 |
Keywords: | COVID-19 Malalties de l'aparell respiratori Oxigenoteràpia Respiració artificial COVID-19 Respiratory diseases Oxygen therapy Artificial respiration |
Issue Date: | 11-Feb-2021 |
Publisher: | BioMed Central |
Abstract: | 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. |
Note: | Reproducció del document publicat a: https://doi.org/10.1186/s13054-021-03469-w |
It is part of: | Critical Care, 2021, vol. 25, num. 1, p. 58 |
URI: | http://hdl.handle.net/2445/185989 |
Related resource: | https://doi.org/10.1186/s13054-021-03469-w |
ISSN: | 1364-8535 |
Appears in Collections: | Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) Articles publicats en revistes (Medicina) |
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