Miray Kübra TURGUT AKSU, Emel YILDIZ, Canan BALCI

COVID-19 Pnömonisi ile Yoğun Bakıma Yatan Hastalarda Yüksek Akışlı Nazal Oksijen Tedavisinin Etkinliğinin Retrospektif Olarak Değerlendirilmesi

COVID-19 pnömonisi nedeniyle yoğun bakım ünitesine (YBÜ) yatırılan hastalar yüksek oranda oksijene ihtiyaç duyarlar. Gelişen kanıtlar ışığında hastalarda, invaziv mekanik ventilasyon (IMV) yerine non-invaziv oksijenasyon stratejileri çok büyük öneme sahip olmuştur. Yüksek akışlı nazal oksijen (High Flow Nasal Oxygen (HFNO)) tedavisi bu yöntemlerden birisidir. HFNO tedavisinin mortaliteyi azalttığına dair literatürde çalışmalar mevcuttur. Çalışmamızda COVID-19 pnömonisine bağlı akut solunum yetmezliğinde HFNO tedavisinin etkinliğini ve sonuçlarını değerlendirmeyi amaçladık. Çalışmaya COVID-19 pnömonisi nedeniyle YBÜ’ne kabul edilen, periferik oksijen saturasyonu (SpO2)

Anahtar Kelimeler:

HFNO, COVID-19, Pnömoni, ROX indeksi

Retrospective Evaluation of the Efficacy of High-Flow Nasal Oxygen Therapy in Intensive Care Patients with COVID-19 Pneumonia

Patients hospitalized in the intensive care unit (ICU) due to COVID-19 pneumonia require high levels of oxygen. In the light of the developing evidence, non-invasive oxygenation strategies instead of invasive mechanical ventilation (IMV) have become of paramount importance in patients. High flow nasal oxygen (High Flow Nasal Oxygen (HFNO)) therapy is one of these methods. There are studies in the literature showing that HFNO treatment reduces mortality. In our study, we aimed to evaluate the efficacy and results of HFNO treatment in acute respiratory failure due to COVID-19 pneumonia. The study included 23 patients who were admitted to the ICU due to COVID-19 pneumonia, had peripheral oxygen saturation (SpO2)

Keywords:

COVID-19, Pneumonıa, HFNO, ROX index,

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Ambrosino I, Barbagelata E, Ortona E, Ruggieri A, Massiah G, Giannico OV. 2020. Gender differences in patients with COVID-19: a narrative review. Arch Chest Diseas, 90(2). DOI: 10.4081/monaldi.2020.1389.
Bain W, Yang H, Shah FA, Suber T, Drohan C, Al-Yousif N. 2021. COVID-19 versus Non-COVID-19 acute respiratory distress syndrome: comparison of demographics, physiologic parameters, ınflammatory biomarkers, and clinical outcomes. Ann Amer Thorac Soc, 18(7): 1202-1210.
Calligaro GL, Lalla U, Audley G, Gina P, Miller MG, Mendelson M. 2020. Theutility of high-flow nasal oxygen for severe COVID-19 pneumonia in a resource-constrained setting: A multi-centre prospective observational study. E Clin Med, 28: 100570. DOI: 10.1016/j.eclinm.2020.100570.
Chang R, Elhusseiny KM, Yeh YC, Sun WZ. 2021. COVID-19 ICU and mechanical ventilation patient characteristics and outcomes-A systematic review and meta-analysis. PLoS One, 16(2): e0246318.
Cheng H, Wang Y, Wang GQ. 2020. Organ-protective effect of angiotensin-converting enzyme 2 and its effect on the prognosis of COVID-19. J Med Virol, 92(7): 726-730.
Franco C, Facciolongo N, Tonelli R, Dongilli R, Vianello A, Pisani L. 2020. Feasibility and clinical impact of out-of-ICU noninvasive respiratory support in patients with COVID-19-related pneumonia. Eur Respir J, 56(5): 2002130.
Grasselli G, Greco M, Zanella A, Albano G, Antonelli M, Bellani G. 2020. Risk factors associated with mortality among patients with COVID-19 in ıntensive care units in Lombardy, Italy. JAMA Intern Med, 180(10): 1345-1355.
Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. 2020. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirüs disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med, 58(7): 1021-1028.
Hernandez-Romieu AC, Adelman MW, Hockstein MA, Robichaux CJ, Edwards JA, Fazio JC. 2020 Timing of ıntubation and mortality among critically ill Coronavirus disease 2019 patients: A single-center cohort study. Crit Care Med, 48(11): 1045-1053.
Hu B, Guo H, Zhou P, Shi ZL. 2020. Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol, 19: 141-154.
Jhou HJ, Chen PH, Lin C, Yang LY, Lee CH, Peng CK. 2020. High-flow nasal cannula therapy as apneic oxygenation during endotracheal intubation in critically ill patients in the intensive care unit: a systematic review and meta-analysis. Sci Rep, 10(1): 3541.
Jin JM, Bai P, He W, Wu F, Liu XF, Han DM. 2020. Gender differences in patients with COVID-19: Focus on severity and mortality. Front Pub Health, 8: 152.
Kang BJ, Koh Y, Lim C-M, Huh JW, Baek S, Han M. 2015. Failure of high-flow nasal cannula therapy may delay intubation and increase mortality. Intensive Care Med, 41(4): 623-632.
Kang YS, Choi SM, Lee J, Park YS, Lee CH, Yoo CG. 2018. Improved oxygenation 48 hours after high-flow nasal cannula oxygen therapy is associated with good outcome in immunocompromised patients with acute respiratory failure. J Thorac Dis, 10(12): 6606-6615.
Koyauchi T, Hasegawa H, Kanata K, Kakutani T, Amano Y, Ozawa Y. 2018. Efficacy and tolerability of high-flow nasal cannula oxygen therapy for hypoxemic respiratory failure in patients with ınterstitial lung disease with do-not-ıntubate orders: A retrospective single-center study. Respiration, 96(4): 323-329.
Liotta EM, Batra A, Clark JR, Shlobin NA, Hoffman SC, Orban ZS. 2020. Frequent neurologic manifestations and encephalopathy-associated morbidity in Covid-19 patients. Ann Clin Trans Neurol, 7(11): 2221-2230.
Liu L, Xie J, Wu W, Chen H, Li S, He H. 2021. A simple nomogram for predicting failure of non-invasive respiratory strategies in adults with COVID-19: a retrospective multi centre study. Lancet Digit Health, 3(3): e166-e174.
Liu W, Zhang Q, Chen J, Xiang R, Song H, Shu S. 2020. Detection of Covid-19 in children in early January 2020 in Wuhan. Engl J Med, 382(14): 1370-1371.
Madabhavi I, Sarkar M, Kadakol N. 2020. COVID-19: A review. Arch Chest Diseas, 90(2). DOI: 10.4081/monaldi.2020.1298.
McDonough G, Khaing P, Treacy T, McGrath C, Yoo EJ. 2020. The use of high-flow nasal oxygen in the ICU as a first linetherapy for acute hypoxemic respiratory failure secondary to Coronavirus disease 2019. Crit Care Explor, 2(10): e0257.
Mellado-Artigas R, Ferreyro BL, Angriman F, Hernández-Sanz M, Arruti E, Torres A. 2021. High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure. Crit Care, 25(1): 58.
Moretti M, Cilione C, Tampieri A, Fracchia C, Marchioni A, Nava S. 2000. Incidence and causes of non-invasive mechanical ventilation failure after initial success, Thorax, 55(10): 819-825.
Onofrio L, Caraglia M, Facchini G, Margherita V, Placido SD, Buonerba C. 2020. Toll-like receptors and COVID-19: A two-faced story with an exciting ending. Future Sci, 6(8). DOI: 10.2144/fsoa-2020-0091.
Ouyang L, Yu M, Zhu Y, Gong J. 2021. Respiratory supports of COVID-19 patients in intensive care unit: A systematic review. Heliyon, 7(4): e06813.
Ozyilmaz E, Ugurlu AO, Nava S. 2014. Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies. BMC Pulm Med, 14: 19.
Panadero C, Abad-Fernández A, Rio-Ramirez MT, AcostaGutierrez CM, Calderon-Alcala M, Lopez-Riolobos C. 2020. High-flow nasal cannula for Acute Respiratory Distress Syndrome (ARDS) due to COVID-19. Multidis Respir Med, 15(1): 693.
Patel M, Gangemi A, Marron R, Chowdhury J, Yousef I, Zheng M. 2020. Retrospective analysis of high flow nasal therapy in COVID-19 related moderate to severe hypoxaemic respiratory failure. BMJ Open Respir, 7(1): 000650.
Pfortmueller CA, Spinetti T, Urman RD, Luedi MM, Schefold JC. 2021. COVID-19-associated acute respiratory distress syndrome (CARDS): Current knowledge on pathophysiology and ICU treatment – A narrative review. Best Pract Res Clin Anaesthesiol, 35(3): 351-368.
Plotnikow GA, Accoce M, Fredes S, Tiribelli N, Setten M, Dorado J. 2021. High-flow oxygen therapy application in chronic obstructive pulmonary disease patients with acute hypercapnic respiratory failure: A multi center study. Crit Care Explor, 3(2): e0337.
Roca O, Messika J, Caralt B, García-de-Acilu M, Sztrymf B, Ricard J-D. 2016. Predicting success of high-flow nasal cannula in pneumonia patients with hypoxemic respiratory failure: Theutility of the ROX index. J Crit Care, 35: 200-205.
Sayan İ, Altınay M, Çınar AS, Türk HŞ, Peker N, Şahin K. 2021. Impact of HFNC application on mortality and intensive care length of stay in acute respiratory failure secondary to COVID-19 pneumonia, Heart Lung, 50(3): 425-429.
Shang X, Wang Y. 2021. Comparison of outcomes of high-flow nasal cannula and noninvasive positive-pressure ventilation in patients with hypoxemia and various APACHE II scores after extubation. Ther Adv Respir Dis, 15: 175346662110042.
Shen Y, Zhang W. 2017. High-flow nasal cannula versus noninvasive positive Pressure ventilation in acute respiratory failure: interaction between PaO2/FiO2 and tidal volume. Crit Care, 21(1): 285.
Teng X, Shen Y, Han M, Yang G, Zha L, Shi J. 2021. The value of high‐flow nasal cannula oxygen therapy in treating novel coronavirüs pneumonia. Eur J Clin Invest, 51(3): e13435. DOI: 10.1111/eci.13435.
Vianello A, Arcaro G, Molena B, Turato C, Sukthi A, Guarnieri G. 2020. High-flow nasal cannula oxygen therapy to treat patients with hypoxemic acute respiratory failure consequent to SARS-CoV-2 infection. Thorax, 75(11): 998-1000.
Xia J, Zhang Y, Ni L, Chen L, Zhou C, Gao C. 2020. High-flow nasal oxygen in Coronavirus disease 2019 patients with acute hypoxemic respiratory failure: A multi center, retrospective cohort study. Crit Care Med, 48(11): e1079-86.
Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H. 2020. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study. Lancet Respir Med, 8(5): 475-481.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z. 2020. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet, 395(10229): 1054-1062.
Zhu Y, Yin H, Zhang R, Wei J. 2017. High-flow nasal cannula oxygen therapy versus conventional oxygen therapy in patients with acute respiratory failure: a systematic review and meta-analysis of randomized controlled trials. BMC Pulm Med, 17(1): 201.
Zou X, Li S, Fang M, Hu M, Bian Y, Ling J. 2020. Acute physiology and chronic health evaluation ıı score as a predictor of hospital mortality in patients of Coronavirus disease 2019. Crit Care Med, 48(8): e 657-65.