<p>Background: Invasive mechanical ventilation is the treatment of choice in COVID-19 patients when hypoxemia persists, despite maximum conventional oxygen administration. Some frail patients with severe hypoxemic respiratory failure are deemed not eligible for invasive mechanical ventilation. Objectives: To investigate whether High-flow nasal cannula (HFNC) in the wards could serve as a rescue therapy in these frail patients. Methods: This retrospective cohort study included frail COVID-19 patients admitted to the hospital between March 9th and May 1st 2020. HFNC therapy was started in the wards. The primary endpoint was the survival rate at hospital discharge. Results: Thirty-two patients with a median age of 79.0 years (74.5–83.0) and a Clinical Frailty Score of 4 out of 9 (3–6) were included. Only 6% reported HFNC tolerability issues. The overall survival rate was 25% at hospital discharge. Conclusions: This study suggests that, when preferred, HFNC in the wards could be a potential rescue therapy for respiratory failure in vulnerable COVID-19 patients.</p>

doi.org/10.1016/j.hrtlng.2021.04.008, hdl.handle.net/1765/135871
Heart and Lung
Erasmus MC: University Medical Center Rotterdam

Job van Steenkiste, Michael C. van Herwerden, Dolf Weller, Christiaan J. van den Bout, T.R. (Rikje) Ruiter, Jan G. den Hollander, … Marinus A. van den Dorpel. (2021). High-flow Nasal Cannula therapy. Heart and Lung, 50(5), 654–659. doi:10.1016/j.hrtlng.2021.04.008