Use of High-Flow Nasal Cannula Oxygen Therapy in Subjects With ARDS: A 1-Year Observational Study.
BACKGROUND: Beneficial effects of high-flow nasal cannula (HFNC) oxygen on oxygenation and respiratory parameters have been reported in a small number of subjects with acute respiratory failure (ARF). We aimed to evaluate its effect in subjects with ARDS. METHODS: This was an observational single-ce...
| Publicado en: | Respiratory Care Vol. 60; no. 2; pp. 162 - 170 |
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| Autores principales: | , , , , , , , |
| Formato: | algorithm research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Feb2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103751041&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103751041 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Feb2015 vid: 60 iid: 2 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 103751041 100710049 10.4187/respcare.03423 NLM25371400 103751041 ppf: 162 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Use of High-Flow Nasal Cannula Oxygen Therapy in Subjects With ARDS: A 1-Year Observational Study. aug: au: Messika, Jonathan Ahmed, Karim Ben Gaudry, Stéphane Miguel-Montanes, Romain Rafat, Cédric Sztrymf, Benjamin Dreyfuss, Didier Ricard, Jean-Damien affil: Assistance Publique-Hôpitaux de Paris, Hôpital Louis Mourier, Service de Réanimation Médico-Chirurgicale, Colombes, France.; Institut National de la Santé et de la Recherche Médicale, Infection, Antimicrobiens, Modélisation, Evolution, Unité Mixte de Recherche 1137, Paris, France.; Université Paris Diderot, Infection, Antimicrobiens, Modélisation, Evolution, Unité Mixte de Recherche 1137, Sorbonne Paris Cité, Paris, France sug: subj: Respiratory Distress Syndrome, Acute Therapy Oxygen Therapy Methods Nasal Cannula Human Descriptive Statistics Nonexperimental Studies Prospective Studies Retrospective Design Academic Medical Centers Record Review Clinical Assessment Tools Male Female Middle Age Respiratory Failure Therapy Data Analysis Software Mann-Whitney U Test Chi Square Test Logistic Regression Paired T-Tests Aged Treatment Outcomes Adult Confidence Intervals Odds Ratio Education, Continuing (Credit) Middle Aged: 45-64 years Aged: 65+ years Adult: 19-44 years Male Female ab: BACKGROUND: Beneficial effects of high-flow nasal cannula (HFNC) oxygen on oxygenation and respiratory parameters have been reported in a small number of subjects with acute respiratory failure (ARF). We aimed to evaluate its effect in subjects with ARDS. METHODS: This was an observational single-center study. Prospectively obtained data were retrospectively analyzed. All patients admitted over 1 y to a university hospital medicosurgical ICU were included. Classification was according to the highest ventilatory support required. HFNC indications were reviewed, and demographics, clinical characteristics, and course of subjects with ARDS according to intubation need were compared RESULTS: Of 607 subjects admitted, 560 required ventilatory or oxygen support, among whom 180 received noninvasive ventilatory support. HFNC was used in 87 subjects and as first-line treatment in 51 subjects (29% of first-line noninvasively treated subjects), 45 of which had ARDS (PaO2 /FIO2 of 137 mm Hg; 22 men, 57.9 y of age). Pneumonia accounted for 82% of ARDS causes. The intubation rate in these subjects was 40%. Higher Simplified Acute Physiology Score II (SAPS II; 46 vs 29, P = .001), occurrence of additional organ failure (76% vs 26%, P = .002), mainly hemodynamic (50% vs 7%, P = .001) or neurological (22% vs 0, P = .01), and trends toward lower PaO2 /FIO2 and higher breathing frequency after HFNC initiation were evidenced in subjects who failed HFNC. Higher SAPS II scores were associated with HFNC failure in multivariate analysis. CONCLUSIONS: In daily care, over one fourth of subjects requiring noninvasive ventilatory support were treated via HFNC, with a high success rate in subjects with severe ARDS. We conclude that HFNC may be considered as first-line therapy in ARF, including patients with ARDS. pubtype: Academic Journal doctype: algorithm research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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