High-flow nasal cannula oxygen therapy in hypoxic patients with COVID-19 pneumonia: A retrospective cohort study confirming the utility of respiratory rate index
Although high-flow nasal cannula (HFNC) oxygen treatment has been frequently used in coronavirus disease 2019 (COVID-19) patients with acute respiratory failure after the 3rd wave of the pandemic in Japan, the usefulness of the indicators of ventilator avoidance, including respiratory rate-oxygenati...
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| Veröffentlicht in: | Respiratory investigation 2022-01, Vol.60 (1), p.146-153 |
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| creator | Takeshita, Yuichiro Terada, Jiro Hirasawa, Yasutaka Kinoshita, Taku Tajima, Hiroshi Koshikawa, Ken Kinouchi, Toru Isaka, Yuri Shionoya, Yu Tada, Yuji Tsushima, Kenji |
| description | Although high-flow nasal cannula (HFNC) oxygen treatment has been frequently used in coronavirus disease 2019 (COVID-19) patients with acute respiratory failure after the 3rd wave of the pandemic in Japan, the usefulness of the indicators of ventilator avoidance, including respiratory rate-oxygenation (ROX) index and other parameters, namely oxygen saturation/fraction of inspired oxygen ratio and respiratory rate (RR), remain unclear.
Between January and May 2021, our institution treated 189 COVID-19 patients with respiratory failure requiring oxygen, among which 39 patients requiring HFNC treatment were retrospectively analyzed. The group that switched from HFNC treatment to conventional oxygen therapy (COT) was defined as the HFNC success group, and the group that switched from HFNC treatment to a ventilator was defined as the HFNC failure group. We followed the patients’ oxygenation parameters for a maximum of 30 days.
HFNC treatment success occurred in 24 of 39 patients (62%) treated with HFNC therapy. Compared with the HFNC failure group, the HFNC success group had a significantly higher degree of RR improvement in the univariate analysis. Logistic regression analysis of HFNC treatment success adjusting for age, respiratory improvement, and a ROX index ≥5.55 demonstrated that an improved RR was associated with HFNC treatment success. The total COT duration was significantly shorter in the HFNC success group than in the HFNC failure group.
HFNC treatment can be useful for ventilator avoidance and allow the quick withdrawal of oxygen administration. RR improvement may be a convenient, useful, and simple indicator of HFNC treatment success. |
| doi_str_mv | 10.1016/j.resinv.2021.10.005 |
| format | Article |
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Between January and May 2021, our institution treated 189 COVID-19 patients with respiratory failure requiring oxygen, among which 39 patients requiring HFNC treatment were retrospectively analyzed. The group that switched from HFNC treatment to conventional oxygen therapy (COT) was defined as the HFNC success group, and the group that switched from HFNC treatment to a ventilator was defined as the HFNC failure group. We followed the patients’ oxygenation parameters for a maximum of 30 days.
HFNC treatment success occurred in 24 of 39 patients (62%) treated with HFNC therapy. Compared with the HFNC failure group, the HFNC success group had a significantly higher degree of RR improvement in the univariate analysis. Logistic regression analysis of HFNC treatment success adjusting for age, respiratory improvement, and a ROX index ≥5.55 demonstrated that an improved RR was associated with HFNC treatment success. The total COT duration was significantly shorter in the HFNC success group than in the HFNC failure group.
HFNC treatment can be useful for ventilator avoidance and allow the quick withdrawal of oxygen administration. RR improvement may be a convenient, useful, and simple indicator of HFNC treatment success.</description><identifier>ISSN: 2212-5345</identifier><identifier>EISSN: 2212-5353</identifier><identifier>DOI: 10.1016/j.resinv.2021.10.005</identifier><identifier>PMID: 34772644</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Cannula ; COVID-19 ; High-flow nasal cannula ; Humans ; Noninvasive Ventilation ; Original ; Oxygen ; Oxygen Inhalation Therapy ; Oxygen Saturation ; Oxygen therapy ; Pneumonia - therapy ; Respiratory failure ; Respiratory Insufficiency - etiology ; Respiratory Insufficiency - therapy ; Respiratory Rate ; Retrospective Studies ; SARS-CoV-2</subject><ispartof>Respiratory investigation, 2022-01, Vol.60 (1), p.146-153</ispartof><rights>2021 The Japanese Respiratory Society</rights><rights>Copyright © 2021 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.</rights><rights>2021 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved. 2021 The Japanese Respiratory Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c463t-8a51c4fc79a991140b90d3d34f5aa3d9a0416eba44594f96c519a2dcf7ae1a43</citedby><cites>FETCH-LOGICAL-c463t-8a51c4fc79a991140b90d3d34f5aa3d9a0416eba44594f96c519a2dcf7ae1a43</cites><orcidid>0000-0001-6706-5595 ; 0000-0002-2202-3495 ; 0000-0002-8299-4250 ; 0000-0001-9019-4053</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34772644$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Takeshita, Yuichiro</creatorcontrib><creatorcontrib>Terada, Jiro</creatorcontrib><creatorcontrib>Hirasawa, Yasutaka</creatorcontrib><creatorcontrib>Kinoshita, Taku</creatorcontrib><creatorcontrib>Tajima, Hiroshi</creatorcontrib><creatorcontrib>Koshikawa, Ken</creatorcontrib><creatorcontrib>Kinouchi, Toru</creatorcontrib><creatorcontrib>Isaka, Yuri</creatorcontrib><creatorcontrib>Shionoya, Yu</creatorcontrib><creatorcontrib>Tada, Yuji</creatorcontrib><creatorcontrib>Tsushima, Kenji</creatorcontrib><title>High-flow nasal cannula oxygen therapy in hypoxic patients with COVID-19 pneumonia: A retrospective cohort study confirming the utility of respiratory rate index</title><title>Respiratory investigation</title><addtitle>Respir Investig</addtitle><description>Although high-flow nasal cannula (HFNC) oxygen treatment has been frequently used in coronavirus disease 2019 (COVID-19) patients with acute respiratory failure after the 3rd wave of the pandemic in Japan, the usefulness of the indicators of ventilator avoidance, including respiratory rate-oxygenation (ROX) index and other parameters, namely oxygen saturation/fraction of inspired oxygen ratio and respiratory rate (RR), remain unclear.
Between January and May 2021, our institution treated 189 COVID-19 patients with respiratory failure requiring oxygen, among which 39 patients requiring HFNC treatment were retrospectively analyzed. The group that switched from HFNC treatment to conventional oxygen therapy (COT) was defined as the HFNC success group, and the group that switched from HFNC treatment to a ventilator was defined as the HFNC failure group. We followed the patients’ oxygenation parameters for a maximum of 30 days.
HFNC treatment success occurred in 24 of 39 patients (62%) treated with HFNC therapy. Compared with the HFNC failure group, the HFNC success group had a significantly higher degree of RR improvement in the univariate analysis. Logistic regression analysis of HFNC treatment success adjusting for age, respiratory improvement, and a ROX index ≥5.55 demonstrated that an improved RR was associated with HFNC treatment success. The total COT duration was significantly shorter in the HFNC success group than in the HFNC failure group.
HFNC treatment can be useful for ventilator avoidance and allow the quick withdrawal of oxygen administration. RR improvement may be a convenient, useful, and simple indicator of HFNC treatment success.</description><subject>Cannula</subject><subject>COVID-19</subject><subject>High-flow nasal cannula</subject><subject>Humans</subject><subject>Noninvasive Ventilation</subject><subject>Original</subject><subject>Oxygen</subject><subject>Oxygen Inhalation Therapy</subject><subject>Oxygen Saturation</subject><subject>Oxygen therapy</subject><subject>Pneumonia - therapy</subject><subject>Respiratory failure</subject><subject>Respiratory Insufficiency - etiology</subject><subject>Respiratory Insufficiency - therapy</subject><subject>Respiratory Rate</subject><subject>Retrospective Studies</subject><subject>SARS-CoV-2</subject><issn>2212-5345</issn><issn>2212-5353</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u2zAMx41hw1p0fYNh0HEXZ5It2fEOA4rsowUK9FLsKjAyHTNwJE-S0_hx9qZTkC7bLtOFIkX-KfKXZW8FXwguqg_bhcdAdr8oeCFSaMG5epFdFoUoclWq8uX5LtVFdh3ClqdTqUKK6nV2Ucq6LiopL7Oft7Tp825wT8xCgIEZsHYagLnDvEHLYo8expmRZf08ugMZNkIktDGwJ4o9Wz18v_uci4aNFqedswQf2Q3zGL0LI5pIe2TG9c5HFuLUzsmxHfkd2c1RnE2RBoozc10qCiN5iM7PLBlMTVs8vMledTAEvH62V9nj1y-Pq9v8_uHb3ermPjeyKmO-BCWM7EzdQNMIIfm64W3ZlrJTAGXbAE-j4xqkVI3smsoo0UDRmq4GFCDLq-zTSXac1jtsTZrQw6BHTzvws3ZA-t8XS73euL1eKlWppUgC758FvPsxYYh6R8HgMIBFNwVdqKZWnJdimVLlKdWkJQWP3bmN4PrIV2_1ia8-8j1GE99U9u7vL56LftP8MwOmPe0JvQ4moTLYkk8odOvo_x1-AUUmvaQ</recordid><startdate>20220101</startdate><enddate>20220101</enddate><creator>Takeshita, Yuichiro</creator><creator>Terada, Jiro</creator><creator>Hirasawa, Yasutaka</creator><creator>Kinoshita, Taku</creator><creator>Tajima, Hiroshi</creator><creator>Koshikawa, Ken</creator><creator>Kinouchi, Toru</creator><creator>Isaka, Yuri</creator><creator>Shionoya, Yu</creator><creator>Tada, Yuji</creator><creator>Tsushima, Kenji</creator><general>Elsevier B.V</general><general>The Japanese Respiratory Society. Published by Elsevier B.V</general><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><orcidid>https://orcid.org/0000-0001-6706-5595</orcidid><orcidid>https://orcid.org/0000-0002-2202-3495</orcidid><orcidid>https://orcid.org/0000-0002-8299-4250</orcidid><orcidid>https://orcid.org/0000-0001-9019-4053</orcidid></search><sort><creationdate>20220101</creationdate><title>High-flow nasal cannula oxygen therapy in hypoxic patients with COVID-19 pneumonia: A retrospective cohort study confirming the utility of respiratory rate index</title><author>Takeshita, Yuichiro ; Terada, Jiro ; Hirasawa, Yasutaka ; Kinoshita, Taku ; Tajima, Hiroshi ; Koshikawa, Ken ; Kinouchi, Toru ; Isaka, Yuri ; Shionoya, Yu ; Tada, Yuji ; Tsushima, Kenji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c463t-8a51c4fc79a991140b90d3d34f5aa3d9a0416eba44594f96c519a2dcf7ae1a43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cannula</topic><topic>COVID-19</topic><topic>High-flow nasal cannula</topic><topic>Humans</topic><topic>Noninvasive Ventilation</topic><topic>Original</topic><topic>Oxygen</topic><topic>Oxygen Inhalation Therapy</topic><topic>Oxygen Saturation</topic><topic>Oxygen therapy</topic><topic>Pneumonia - therapy</topic><topic>Respiratory failure</topic><topic>Respiratory Insufficiency - etiology</topic><topic>Respiratory Insufficiency - therapy</topic><topic>Respiratory Rate</topic><topic>Retrospective Studies</topic><topic>SARS-CoV-2</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Takeshita, Yuichiro</creatorcontrib><creatorcontrib>Terada, Jiro</creatorcontrib><creatorcontrib>Hirasawa, Yasutaka</creatorcontrib><creatorcontrib>Kinoshita, Taku</creatorcontrib><creatorcontrib>Tajima, Hiroshi</creatorcontrib><creatorcontrib>Koshikawa, Ken</creatorcontrib><creatorcontrib>Kinouchi, Toru</creatorcontrib><creatorcontrib>Isaka, Yuri</creatorcontrib><creatorcontrib>Shionoya, Yu</creatorcontrib><creatorcontrib>Tada, Yuji</creatorcontrib><creatorcontrib>Tsushima, Kenji</creatorcontrib><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>Respiratory investigation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takeshita, Yuichiro</au><au>Terada, Jiro</au><au>Hirasawa, Yasutaka</au><au>Kinoshita, Taku</au><au>Tajima, Hiroshi</au><au>Koshikawa, Ken</au><au>Kinouchi, Toru</au><au>Isaka, Yuri</au><au>Shionoya, Yu</au><au>Tada, Yuji</au><au>Tsushima, Kenji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High-flow nasal cannula oxygen therapy in hypoxic patients with COVID-19 pneumonia: A retrospective cohort study confirming the utility of respiratory rate index</atitle><jtitle>Respiratory investigation</jtitle><addtitle>Respir Investig</addtitle><date>2022-01-01</date><risdate>2022</risdate><volume>60</volume><issue>1</issue><spage>146</spage><epage>153</epage><pages>146-153</pages><issn>2212-5345</issn><eissn>2212-5353</eissn><abstract>Although high-flow nasal cannula (HFNC) oxygen treatment has been frequently used in coronavirus disease 2019 (COVID-19) patients with acute respiratory failure after the 3rd wave of the pandemic in Japan, the usefulness of the indicators of ventilator avoidance, including respiratory rate-oxygenation (ROX) index and other parameters, namely oxygen saturation/fraction of inspired oxygen ratio and respiratory rate (RR), remain unclear.
Between January and May 2021, our institution treated 189 COVID-19 patients with respiratory failure requiring oxygen, among which 39 patients requiring HFNC treatment were retrospectively analyzed. The group that switched from HFNC treatment to conventional oxygen therapy (COT) was defined as the HFNC success group, and the group that switched from HFNC treatment to a ventilator was defined as the HFNC failure group. We followed the patients’ oxygenation parameters for a maximum of 30 days.
HFNC treatment success occurred in 24 of 39 patients (62%) treated with HFNC therapy. Compared with the HFNC failure group, the HFNC success group had a significantly higher degree of RR improvement in the univariate analysis. Logistic regression analysis of HFNC treatment success adjusting for age, respiratory improvement, and a ROX index ≥5.55 demonstrated that an improved RR was associated with HFNC treatment success. The total COT duration was significantly shorter in the HFNC success group than in the HFNC failure group.
HFNC treatment can be useful for ventilator avoidance and allow the quick withdrawal of oxygen administration. RR improvement may be a convenient, useful, and simple indicator of HFNC treatment success.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>34772644</pmid><doi>10.1016/j.resinv.2021.10.005</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-6706-5595</orcidid><orcidid>https://orcid.org/0000-0002-2202-3495</orcidid><orcidid>https://orcid.org/0000-0002-8299-4250</orcidid><orcidid>https://orcid.org/0000-0001-9019-4053</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Cannula COVID-19 High-flow nasal cannula Humans Noninvasive Ventilation Original Oxygen Oxygen Inhalation Therapy Oxygen Saturation Oxygen therapy Pneumonia - therapy Respiratory failure Respiratory Insufficiency - etiology Respiratory Insufficiency - therapy Respiratory Rate Retrospective Studies SARS-CoV-2 |
| title | High-flow nasal cannula oxygen therapy in hypoxic patients with COVID-19 pneumonia: A retrospective cohort study confirming the utility of respiratory rate index |
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