Noninvasive ventilation and high-flow nasal cannula in patients with acute hypoxemic respiratory failure by covid-19: A retrospective study of the feasibility, safety and outcomes

Autor(es)

Costa, Wesla Neves da Silva ; Miguel, Juliana Padovezi ; Prado, Fabiana dos Santos ; Santos de Mello Lula, Liz Helena ; Junqueira Amarante, Gustavo Adolpho ; Righetti, Renato Fraga ; Yamaguti, Wellington Pereira

• Tipo de documento: Artigo Científico
• Fonte: Respiratory Physiology & Neurobiology; v. 298, p. 7-pg., 2022-04-01.

Resumo

Background: Noninvasive ventilation (NIV) and High-flow nasal cannula (HFNC) are the main forms of treatment for acute respiratory failure. This study aimed to evaluate the effect, safety, and applicability of the NIV and HFNC in patients with acute hypoxemic respiratory failure (AHRF) caused by COVID-19. Methods: In this retrospective study, we monitored the effect of NIV and HFNC on the SpO(2) and respiratory rate before, during, and after treatment, length of stay, rates of endotracheal intubation, and mortality in patients with AHRF caused by COVID-19. Additionally, data regarding RT-PCR from physiotherapists who were directly involved in assisting COVID-19 patients and non-COVID-19. Results: 62.2 % of patients were treated with HFNC. ROX index increased during and after NIV and HFNC treatment (P < 0.05). SpO(2) increased during NIV treatment (P < 0.05), but was not maintained after treatment (P = 0.17). In addition, there was no difference in the respiratory rate during or after the NIV (P = 0.95) or HFNC (P = 0.60) treatment. The mortality rate was 35.7 % for NIV vs 21.4 % for HFNC (P = 0.45), while the total endotracheal intubation rate was 57.1 % for NIV vs 69.6 % for HFNC (P = 0.49). Two adverse events occurred during treatment with NIV and eight occurred during treatment with HFNC. There was no difference in the physiotherapists who tested positive for SARS-COV-2 directly involved in assisting COVID-19 patients and non-COVID-19 ones (P = 0.81). Conclusion: The application of NIV and HFNC in the critical care unit is feasible and associated with favorable outcomes. In addition, there was no increase in the infection of physiotherapists with SARS-CoV-2. (AU)

• Processo FAPESP: 18/16832-9 - Efeitos da estimulação elétrica na prevenção da perda de massa muscular em pacientes com sepse e choque séptico: ensaio clínico randomizado, controlado e duplo-cego
• Beneficiário: Wellington Pereira dos Santos Yamaguti
• Modalidade de apoio: Auxílio à Pesquisa - Regular