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Inicio Medicina Clínica (English Edition) Benefits of early use of high-flow-nasal-cannula (HFNC) in patients with COVID-1...
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Vol. 158. Issue 11.
Pages 540-542 (June 2022)
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Vol. 158. Issue 11.
Pages 540-542 (June 2022)
Brief report
Benefits of early use of high-flow-nasal-cannula (HFNC) in patients with COVID-19 associated pneumonia
Beneficio del empleo precoz de la oxigenoterapia nasal de alto flujo (ONAF) en pacientes con neumonía por SARS-CoV-2
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Laura García-Pereña, Violeta Ramos Sesma, María Lucía Tornero Divieso, Alfonso Lluna Carrascosa, Sara Velasco Fuentes, Jorge Parra-Ruiz
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jorge.parra@grupohla.com

Corresponding author.
Servicio de Medicina Interna, Hospital HLA Inmaculada, Granada, Spain
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Abstract
Introduction

Severe COVID-19 is associated with hypoxemic bilateral pneumonia that leads to mechanical ventilation in a considerable proportion of patients. To the best of our knowledge, there are no recommendations about the best time to initiate high flow nasal cannula (HFNC).

Patients and methods

Retrospective study of all patients admitted for COVID-19 pneumonia who required HNFO between March 2020 and February 2021. Patients were grouped in early HNFC or late HNFC, according to the modified Kirby index.

Results

53 patients were included. Forty-four of them were included in the early HFNC and 9 in late HNFC. There were no statistically significant clinical-epidemiological differences. Early use of HFNC was associated with a decrease in the need for intubation (29.5 vs. 66.6%, p = 0.044), hospital stay (18.8 d vs. 36 d, p = 0.022) and mortality (22.7 vs. 55.5%, p = 0.061).

Conclusions

Early HFNC use is associated with a decrease in the need for intubation, mortality and overall hospital stay.

Keywords:
HNFC
Kirby index
Pneumonia
COVID-19
Resumen
Introducción

La COVID-19 grave se asocia con una neumonía bilateral hipoxemiante, que desemboca en la necesidad de ventilación mecánica en un considerable número de pacientes. Hasta la fecha no existen recomendaciones acerca del momento óptimo para el inicio de la ONAF.

Pacientes y métodos

Estudio retrospectivo de todos los pacientes ingresados por neumonía por COVID-19 y que precisaron ONAF entre marzo de 2020 y febrero de 2021. Se agruparon los pacientes en función del momento de inicio de la ONAF de acuerdo con la PaFi modificada.

Resultados

Se incluyeron 53 pacientes, en 44 se inició la ONAF precozmente y en nueve de ellos se inició tardíamente. No existieron diferencias clínico-epidemiológicas significativas. La utilización precoz de la ONAF se asoció con una disminución de la necesidad de intubación (29,5 vs. 66,6%, p = 0,044), de la estancia hospitalaria (18,8 d vs. 36 d, p = 0,022) y de la mortalidad (22,7 vs. 55,5%, p = 0,061).

Conclusiones

El empleo precoz de la ONAF se asocia con una disminución de la necesidad de intubación, de la mortalidad y de la estancia hospitalaria global.

Palabras clave:
ONAF
Índice de Kirby
Neumonía
COVID-19

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