High-Flow Nasal Cannula Oxygenation in Older Patients with SARS-CoV-2-Related Acute Respiratory Failure

High-Flow Nasal Cannula Oxygenation in Older Patients with SARS-CoV-2-Related Acute Respiratory Failure

Authors

  • Faris Putra Haryanto Universitas Lampung
  • Khadafi Indrawan Medical Faculty of Lampung University
  • Ari Wahyuni Medical Faculty of Lampung University

DOI:

https://doi.org/10.53089/medula.v11i2.313

Abstract

Currently, In this World, many cases about comparing the mortality and comfort associated with method of high-flow nasal cannula oxygenation (HFNCO) and high-concentration mask (HCM) in older SARS-CoV-2 infected patients done hospitalized in non-intensive care units. In this retrospective cohort study, author included all consecutive patients aged 75 years and older who were hospitalized for acute respiratory failure in either an acute geriatric unit or an acute pulmonary care unit, and tested positive for SARS-CoV-2. This journal compared the in-hospital prognosis between patients treated with HFNCO and patients treated with HCM. To determinate another bias factor, this journal created a propensity score for HFNCO. From March 2020 to January 2021, 67 patients (median age 87 years, 41 men) were hospitalized with SARS-CoV-2-related akut respiratory failure, of whom 41 (61%) received HFNCO and 26 (39%) did not. Age and comorbidities did not significantly differ in the two groups, whereas clinical presentation was more severe in the HFNCO group (NEW2 score: 8 (5–11) vs. 7 (5–8), p = 0.02, and Sp02/Fi02: 88 (98–120) vs. 117 (114–148), p = 0.03). Seven (17%) vs. two (5%) patients survived at 30 days in the HFNCO and HCM group, respectively. Overall, HFNCO was significantly associated with greater survival (adjusted hazard ratio (AHR) 0.57, 95% CI 0.33–0.99; p = 0.04). HFNCO use was associated with a lower need for morphine (AHR 0.39, 95% CI 0.21–0.71; p = 0.005), but not for midazolam (AHR 0.66, 95% CI 0.37–1.19; p = 0.17). In conclusion, HFNCO use in non-intensive care units may reduce mortality and discomfort in older inpatients with SARS-CoV-2-related akut respiratory failure.

 

References

Xu J, Yang X, Huang C, Zou X, Zhou T, Pan S, et al. A Novel Risk-Stratification Models of the High-Flow Nasal Cannula Therapy in COVID-19 Patients With Hypoxemic Respiratory Failure. Front Med. 2020.

Hacquin A, Perret M, Manckoundia P, Bonniaud P, Beltramo G, Georges M, et al. High-flow nasal cannula oxygenation in older patients with sars-cov-2-related acute respiratory failure. J Clin Med. 2021;10(16).

Zerah L, Baudouin É, Pépin M, Mary M, Krypciak S, Bianco C, et al. Clinical Characteristics and Outcomes of 821 Older Patients with SARS-Cov-2 Infection Admitted to Acute Care Geriatric Wards. Journals Gerontol - Ser A Biol Sci Med Sci. 2021.

Mendes A, Serratrice C, Herrmann FR, Genton L, Périvier S, Scheffler M, et al. Predictors of In-Hospital Mortality in Older Patients With COVID-19: The COVIDAge Study. J Am Med Dir Assoc. 2020.

Farrell TW, Ferrante LE, Brown T, Francis L, Widera E, Rhodes R, et al. AGS Position Statement: Resource Allocation Strategies and Age-Related Considerations in the COVID-19 Era and Beyond. J Am Geriatr Soc. 2020.

Franco C, Facciolongo N, Tonelli R, Dongilli R, Vianello A, Pisani L, et al. Feasibility and clinical impact of out-of-ICU noninvasive respiratory support in patients with COVID-19-related pneumonia. Eur Respir J. 2020.

Papazian L, Corley A, Hess D, Fraser JF, Frat JP, Guitton C, et al. Use of high-flow nasal cannula oxygenation in ICU adults: a narrative review. Intensive Care Medicine. 2016.

Mellado-Artigas R, Mujica LE, Ruiz ML, Ferreyro BL, Angriman F, Arruti E, et al. Predictors of failure with high-flow nasal oxygen therapy in COVID-19 patients with acute respiratory failure: a multicenter observational study. J Intensive Care. 2021.

M. N, W. F, L. W, M. W, W. W, K. K. Spontaneous pneumothorax in covid-19 patients treated with high-flow nasal cannula outside the ICU: A case series. Int J Environ Res Public Health. 2021.

Nishimura M. High-flow nasal cannula oxygen therapy in adults: Physiological benefits, indication, clinical benefits, and adverse effects. Respir Care. 2016.

Lagier JC, Amrane S, Mailhe M, Gainnier M, Arlotto S, Gentile S, et al. High-flow oxygen therapy in elderly patients infected with SARS-CoV2 with a contraindication for transfer to an intensive care unit: A preliminary report. Int J Infect Dis. 2021.

Lee JY, Kim HA, Huh K, Hyun M, Rhee JY, Jang S, et al. Risk factors for mortality and respiratory support in elderly patients hospitalized with COVID-19 in Korea. J Korean Med Sci. 2020.

Hakim R, Watanabe-Tejada L, Sukhal S, Tulaimat A. Acute respiratory failure in randomized trials of noninvasive respiratory support: A systematic review of definitions, patient characteristics, and criteria for intubation. J Crit Care. 2020.

Nishimura M. High-flow nasal cannula oxygen therapy in adults. Journal of Intensive Care. 2015.

Soffler MI, Rose A, Hayes MM, Banzett R, Schwartzstein RM. Treatment of acute dyspnea with morphine to avert respiratory failure. Annals of the American Thoracic Society. 2017.

Prommer E. Midazolam: an essential palliative care drug. Palliative Care and Social Practice. 2020.

Young CC, Prielipp RC. Benzodiazepines in the intensive care unit. Crit Care Clin. 2001.

Cuquemelle E, Pham T, Papon JF, Louis B, Danin PE, Brochard L. Heated and humidified high-flow oxygen therapy reduces discomfort during hypoxemic respiratory failure. Respir Care. 2012.

Frat J-P, Thille AW, Mercat A, Girault C, Ragot S, Perbet S, et al. High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure. N Engl J Med. 2015.

Lewis SR, Baker PE, Parker R, Smith AF. High-flow nasal cannulae for respiratory support in adult intensive care patients. Cochrane Database of Systematic Reviews. 2021.

Muntsant A, Giménez-Llort L. Impact of Social Isolation on the Behavioral, Functional Profiles, and Hippocampal Atrophy Asymmetry in Dementia in Times of Coronavirus Pandemic (COVID-19): A Translational Neuroscience Approach. Front Psychiatry. 2020.

Zaporowska-Stachowiak I, Szymański K, Oduah MT, Stachowiak-Szymczak K, Łuczak J, Sopata M. Midazolam: Safety of use in palliative care: A systematic critical review. Biomedicine and Pharmacotherapy. 2019.

Published

2021-12-19

How to Cite

Haryanto, F. P., Khadafi Indrawan, & Ari Wahyuni. (2021). High-Flow Nasal Cannula Oxygenation in Older Patients with SARS-CoV-2-Related Acute Respiratory Failure: High-Flow Nasal Cannula Oxygenation in Older Patients with SARS-CoV-2-Related Acute Respiratory Failure. Medical Profession Journal of Lampung, 11(2), 183-188. https://doi.org/10.53089/medula.v11i2.313