High-flow Nasal Cannula therapy: A feasible treatment for vulnerable elderly COVID-19 patients in the wards
•HFNC is a potential feasible rescue respiratory treatment strategy for frail elderly COVID-19 patients.•Using HFNC in fragile COVID-19 patients in the wards results in a survival rate of 25%.•For fragile COVID-19 ICU and frail HFNC patients in the wards mortality is comparable. Invasive mechanical...
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| Veröffentlicht in: | Heart & lung 2021-09, Vol.50 (5), p.654-659 |
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| creator | van Steenkiste, Job van Herwerden, Michael C. Weller, Dolf van den Bout, Christiaan J. Ruiter, Rikje den Hollander, Jan G. el Moussaoui, Rachida Verhoeven, Gert T. van Noord, Charlotte van den Dorpel, Marinus A. |
| description | •HFNC is a potential feasible rescue respiratory treatment strategy for frail elderly COVID-19 patients.•Using HFNC in fragile COVID-19 patients in the wards results in a survival rate of 25%.•For fragile COVID-19 ICU and frail HFNC patients in the wards mortality is comparable.
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.
To investigate whether High-flow nasal cannula (HFNC) in the wards could serve as a rescue therapy in these frail patients.
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.
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.
This study suggests that, when preferred, HFNC in the wards could be a potential rescue therapy for respiratory failure in vulnerable COVID-19 patients. |
| doi_str_mv | 10.1016/j.hrtlng.2021.04.008 |
| format | Article |
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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.
To investigate whether High-flow nasal cannula (HFNC) in the wards could serve as a rescue therapy in these frail patients.
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.
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.
This study suggests that, when preferred, HFNC in the wards could be a potential rescue therapy for respiratory failure in vulnerable COVID-19 patients.</description><identifier>ISSN: 0147-9563</identifier><identifier>EISSN: 1527-3288</identifier><identifier>DOI: 10.1016/j.hrtlng.2021.04.008</identifier><identifier>PMID: 34098235</identifier><language>eng</language><publisher>NEW YORK: Elsevier Inc</publisher><subject>Aged ; Cannula ; Cardiac & Cardiovascular Systems ; Cardiovascular System & Cardiology ; COVID-19 ; Frailty ; High-flow Nasal Cannula ; Hospitals ; Humans ; Intensive care unit ; Life Sciences & Biomedicine ; Noninvasive Ventilation ; Nursing ; Oxygen Inhalation Therapy ; Respiratory Insufficiency - therapy ; Respiratory System ; Retrospective Studies ; SARS-CoV-2 ; Science & Technology</subject><ispartof>Heart & lung, 2021-09, Vol.50 (5), p.654-659</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><rights>2021 Elsevier Inc. All rights reserved. 2021 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>10</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000680428700014</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c529t-8fd2b5087ca6e84dda84446a8ba61edf87a917ee81feac94f8a03ce0bd5860ed3</citedby><cites>FETCH-LOGICAL-c529t-8fd2b5087ca6e84dda84446a8ba61edf87a917ee81feac94f8a03ce0bd5860ed3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.hrtlng.2021.04.008$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,315,781,785,886,3551,27929,27930,39263,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34098235$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Steenkiste, Job</creatorcontrib><creatorcontrib>van Herwerden, Michael C.</creatorcontrib><creatorcontrib>Weller, Dolf</creatorcontrib><creatorcontrib>van den Bout, Christiaan J.</creatorcontrib><creatorcontrib>Ruiter, Rikje</creatorcontrib><creatorcontrib>den Hollander, Jan G.</creatorcontrib><creatorcontrib>el Moussaoui, Rachida</creatorcontrib><creatorcontrib>Verhoeven, Gert T.</creatorcontrib><creatorcontrib>van Noord, Charlotte</creatorcontrib><creatorcontrib>van den Dorpel, Marinus A.</creatorcontrib><title>High-flow Nasal Cannula therapy: A feasible treatment for vulnerable elderly COVID-19 patients in the wards</title><title>Heart & lung</title><addtitle>HEART LUNG</addtitle><addtitle>Heart Lung</addtitle><description>•HFNC is a potential feasible rescue respiratory treatment strategy for frail elderly COVID-19 patients.•Using HFNC in fragile COVID-19 patients in the wards results in a survival rate of 25%.•For fragile COVID-19 ICU and frail HFNC patients in the wards mortality is comparable.
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.
To investigate whether High-flow nasal cannula (HFNC) in the wards could serve as a rescue therapy in these frail patients.
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.
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.
This study suggests that, when preferred, HFNC in the wards could be a potential rescue therapy for respiratory failure in vulnerable COVID-19 patients.</description><subject>Aged</subject><subject>Cannula</subject><subject>Cardiac & Cardiovascular Systems</subject><subject>Cardiovascular System & Cardiology</subject><subject>COVID-19</subject><subject>Frailty</subject><subject>High-flow Nasal Cannula</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Intensive care unit</subject><subject>Life Sciences & Biomedicine</subject><subject>Noninvasive Ventilation</subject><subject>Nursing</subject><subject>Oxygen Inhalation Therapy</subject><subject>Respiratory Insufficiency - therapy</subject><subject>Respiratory System</subject><subject>Retrospective Studies</subject><subject>SARS-CoV-2</subject><subject>Science & Technology</subject><issn>0147-9563</issn><issn>1527-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>EIF</sourceid><recordid>eNqNkc2O0zAURiMEYjoDb4CQl0ijFP8lcVggjcLAjDRiNsDWcuyb1sWNi-206tvjqqXABuGNLd1zP1_7FMUrgucEk_rtar4MyY2LOcWUzDGfYyyeFDNS0aZkVIinxQwT3pRtVbOL4jLGFc6L1c3z4oJx3ArKqlnx_c4uluXg_A59VlE51KlxnJxCaQlBbfbv0A0aQEXbO0ApgEprGBMafEDbyY2ZORTAGQhuj7rHb_cfStKijUo2cxHZ8ZCEdiqY-KJ4NigX4eVpvyq-frz90t2VD4-f7rubh1JXtE2lGAztKywarWoQ3BglOOe1Er2qCZhBNKolDYAgeTDd8kEozDTg3lSixmDYVfH-mLuZ-jUYnQcJyslNsGsV9tIrK_-ujHYpF34rBeGiakgOeHMKCP7HBDHJtY0anFMj-ClKWrGW4pZVLKP8iOrgYwwwnK8hWB48yZU8epIHTxJzmT3lttd_jnhu-iUmA9dHYAe9H6LOv6nhjGWRtcCciiafCM-0-H-6synb8WPnpzH9_izIRrYWgjy1GxtAJ2m8_fdTfgLU2ckZ</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>van Steenkiste, Job</creator><creator>van Herwerden, Michael C.</creator><creator>Weller, Dolf</creator><creator>van den Bout, Christiaan J.</creator><creator>Ruiter, Rikje</creator><creator>den Hollander, Jan G.</creator><creator>el Moussaoui, Rachida</creator><creator>Verhoeven, Gert T.</creator><creator>van Noord, Charlotte</creator><creator>van den Dorpel, Marinus A.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210901</creationdate><title>High-flow Nasal Cannula therapy: A feasible treatment for vulnerable elderly COVID-19 patients in the wards</title><author>van Steenkiste, Job ; van Herwerden, Michael C. ; Weller, Dolf ; van den Bout, Christiaan J. ; Ruiter, Rikje ; den Hollander, Jan G. ; el Moussaoui, Rachida ; Verhoeven, Gert T. ; van Noord, Charlotte ; van den Dorpel, Marinus A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c529t-8fd2b5087ca6e84dda84446a8ba61edf87a917ee81feac94f8a03ce0bd5860ed3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Cannula</topic><topic>Cardiac & Cardiovascular Systems</topic><topic>Cardiovascular System & Cardiology</topic><topic>COVID-19</topic><topic>Frailty</topic><topic>High-flow Nasal Cannula</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intensive care unit</topic><topic>Life Sciences & Biomedicine</topic><topic>Noninvasive Ventilation</topic><topic>Nursing</topic><topic>Oxygen Inhalation Therapy</topic><topic>Respiratory Insufficiency - therapy</topic><topic>Respiratory System</topic><topic>Retrospective Studies</topic><topic>SARS-CoV-2</topic><topic>Science & Technology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Steenkiste, Job</creatorcontrib><creatorcontrib>van Herwerden, Michael C.</creatorcontrib><creatorcontrib>Weller, Dolf</creatorcontrib><creatorcontrib>van den Bout, Christiaan J.</creatorcontrib><creatorcontrib>Ruiter, Rikje</creatorcontrib><creatorcontrib>den Hollander, Jan G.</creatorcontrib><creatorcontrib>el Moussaoui, Rachida</creatorcontrib><creatorcontrib>Verhoeven, Gert T.</creatorcontrib><creatorcontrib>van Noord, Charlotte</creatorcontrib><creatorcontrib>van den Dorpel, Marinus A.</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Heart & lung</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Steenkiste, Job</au><au>van Herwerden, Michael C.</au><au>Weller, Dolf</au><au>van den Bout, Christiaan J.</au><au>Ruiter, Rikje</au><au>den Hollander, Jan G.</au><au>el Moussaoui, Rachida</au><au>Verhoeven, Gert T.</au><au>van Noord, Charlotte</au><au>van den Dorpel, Marinus A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High-flow Nasal Cannula therapy: A feasible treatment for vulnerable elderly COVID-19 patients in the wards</atitle><jtitle>Heart & lung</jtitle><stitle>HEART LUNG</stitle><addtitle>Heart Lung</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>50</volume><issue>5</issue><spage>654</spage><epage>659</epage><pages>654-659</pages><issn>0147-9563</issn><eissn>1527-3288</eissn><abstract>•HFNC is a potential feasible rescue respiratory treatment strategy for frail elderly COVID-19 patients.•Using HFNC in fragile COVID-19 patients in the wards results in a survival rate of 25%.•For fragile COVID-19 ICU and frail HFNC patients in the wards mortality is comparable.
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.
To investigate whether High-flow nasal cannula (HFNC) in the wards could serve as a rescue therapy in these frail patients.
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.
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.
This study suggests that, when preferred, HFNC in the wards could be a potential rescue therapy for respiratory failure in vulnerable COVID-19 patients.</abstract><cop>NEW YORK</cop><pub>Elsevier Inc</pub><pmid>34098235</pmid><doi>10.1016/j.hrtlng.2021.04.008</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Heart & lung, 2021-09, Vol.50 (5), p.654-659 |
| issn | 0147-9563 1527-3288 |
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| subjects | Aged Cannula Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology COVID-19 Frailty High-flow Nasal Cannula Hospitals Humans Intensive care unit Life Sciences & Biomedicine Noninvasive Ventilation Nursing Oxygen Inhalation Therapy Respiratory Insufficiency - therapy Respiratory System Retrospective Studies SARS-CoV-2 Science & Technology |
| title | High-flow Nasal Cannula therapy: A feasible treatment for vulnerable elderly COVID-19 patients in the wards |
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