Respiratory failure & ventilation
Safety and Outcome of High-Flow Nasal Oxygen Therapy Outside ICU Setting in Hypoxemic Patients With COVID-19*
Authors' conclusion
In this large cohort of hypoxemic patients with COVID-19, initiation of HFNO outside the ICU was safe, and clinical outcomes were similar to initiation in the ICU.
Study context
- Population
- Adults treated with high-flow nasal oxygen (HFNO) for COVID-19-associated hypoxemia, respiratory wards and ICUs of 10 hospitals in The Netherlands, December 2020–July 2021; patients with treatment limitations excludedmatched cohort n = 214
- Participants
- 608 adults
- Exposure
- HFNO initiated on the ward vs in the ICU
- Ward startersn = 379
- ICU startersn = 229reference
- Outcome
- Intubation rate
Methodological detailsmulticentre, pragmatic, propensity-matched analysis
- Multicentre
- Pragmatic
- Propensity-matched analysis
Main finding
As reported in the abstract
P = 0.41
Observational data: associations, not effects.
Further findings
- Mortality (matched cohort) · 28 d — 28-d mortality comparable between groups, ward vs ICU starters · matched cohort
- 8% vs 13% · P = 0.28
- ICU-free days (matched cohort) — ICU-free days significantly higher in ward starters, ward vs ICU starters (d) · matched cohort
- 21 vs 17 · P < 0.001
Intubated ward vs ICU starters (subgroup): severity of respiratory failure and outcomes
- Respiratory rate-oxygenation index, ward vs ICU starters
- 3.20 vs 3.38
- PaO2:FiO2 ratio (mm Hg), ward vs ICU starters
- 65 vs 64
- Prone positioning after intubation, ward vs ICU starters
- 81 vs 78%
- Mortality rate, ward vs ICU starters
- 17 vs 25%
- Ventilator-free days at 28 d, ward vs ICU starters
- 15 vs 13 d
- No patient died before endotracheal intubation
- Did not differ; all p values > 0.05
Original publication
Safety and Outcome of High-Flow Nasal Oxygen Therapy Outside ICU Setting in Hypoxemic Patients With COVID-19*. Crit Care Med. Published 19 October 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →