Outcomes following application of high flow nasal cannula and non-invasive ventilation during the second COVID-19 wave in Singapore
Critical Care Conference: 42nd International Symposium on Intensive Care and Emergency Medicine Brussels Belgium
; 27(Supplement 1), 2023.
Article
in English
| EMBASE | ID: covidwho-2317613
ABSTRACT
Introduction:
COVID-19 pneumonia can result in significant morbidity and mortality in affected individuals. Our audit aims to study the respiratory outcomes of patients with COVID-19 pneumonia following the use of HFNC and NIV during the second wave of the pandemic. Method(s) We analysed the outcomes of 94 patients admitted to a tertiary combined HDU/ICU with severe COVID-19 pneumonia requiring non-invasive support between July and December 2021. Result(s) 94 patients were admitted during the study period. ICU mortality rate was 22% (21/94), total in-hospital mortality was 38% (36/94). HFNC was used as first line respiratory support in 58/94 cases, of which 39.6% required intubation. Of those patients who failed HFNC, time to intubation was significantly higher in those patients who passed away than those who were intubated and survived (mean 6.08 days vs 2.86 days, p < 0.05 one sided T-test). In all patients, very late intubation defined as intubation > 5d post admission to ICU, occurred in 6/41 patients, of which the mortality rate was 100%. ROX score performed at 12 h post intubation was unable to discriminate those who succeeded with HFNC and those who required intubation (mean ROX 7.24 vs 7.9, p > 0.05). NIV was used in combination with HFNC pre-intubation in 5/23 HFNC cases with 100% mortality rate. Extubation failure rates were low (5/94) and use of tracheostomy was uncommon (4/94;all 4 survived ICU stay, 3 eventually died in hospital). Conclusion(s) HFNC failure with prolonged use of HFNC and use of multiple non-invasive device strategies before intubation was associated with a high risk of mortality. Conventional measurements of HFNC failure in the form of a 12 h ROX score could not assist the clinician in predicting those patients at risk of HFNC failure.
adult; assisted ventilation; conference abstract; controlled study; coronavirus disease 2019; extubation; female; high flow nasal cannula therapy; hospital mortality; human; in-hospital mortality; intubation; major clinical study; male; mortality rate; mortality risk; noninvasive ventilation; outcome assessment; risk assessment; Singapore; surgery; tracheostomy; treatment failure
Full text:
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Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Critical Care Conference: 42nd International Symposium on Intensive Care and Emergency Medicine Brussels Belgium
Year:
2023
Document Type:
Article
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