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Factors associated with failure of high-flow nasal cannula oxygen therapy in patients with severe COVID-19: a retrospective case series.
Ma, Xiao-Huan; An, Meng-Meng; Yin, Fang; Zhang, Jie; Peng, Meng-Yun; Guan, Hong; Gong, Ping.
  • Ma XH; Department of Emergency, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
  • An MM; Intensive Care Unit, The Second People's Hospital of Dalian, Dalian, Liaoning, China.
  • Yin F; Intensive Care Unit, Affiliated Dalian Friendship Hospital of Dalian Medical University, Dalian, Liaoning, China.
  • Zhang J; Neurosurgical Intensive Care Unit, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.
  • Peng MY; Department of Gynecology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
  • Guan H; College of Nursing, Dalian Medical University, Liaoning, China.
  • Gong P; Department of Nursing, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
J Int Med Res ; 50(5): 3000605221103525, 2022 May.
Article in English | MEDLINE | ID: covidwho-1874964
ABSTRACT

OBJECTIVE:

To identify factors associated with high-flow nasal cannula (HFNC) therapy failure in patients with severe COVID-19.

METHODS:

We retrospectively examined clinical and laboratory data upon admission, treatments, and outcomes of patients with severe COVID-19. Sequential Organ Failure Assessment (SOFA) scores were also calculated.

RESULTS:

Of 54 patients with severe COVID-19, HFNC therapy was successful in 28 (51.9%) and unsuccessful in 26 (48.1%). HFNC therapy failure was more common in patients aged ≥60 years and in men. Compared with patients with successful HFNC therapy, patients with HFNC therapy failure had higher percentages of fatigue, anorexia, and cardiovascular disease; a longer time from symptom onset to diagnosis; higher SOFA scores; a higher body temperature, respiratory rate, and heart rate; more complications, including acute respiratory distress syndrome, septic shock, myocardial damage, and acute kidney injury; a higher C-reactive protein concentration, neutrophil count, and prothrombin time; and a lower arterial partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2). However, male sex, a low PaO2/FiO2, and a high SOFA score were the only independent factors significantly associated with HFNC therapy failure.

CONCLUSIONS:

Male sex, a low PaO2/FiO2, and a high SOFA score were independently associated with HFNC therapy failure in patients with severe COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Insufficiency / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Humans / Male Language: English Journal: J Int Med Res Year: 2022 Document Type: Article Affiliation country: 03000605221103525

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Insufficiency / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Humans / Male Language: English Journal: J Int Med Res Year: 2022 Document Type: Article Affiliation country: 03000605221103525