The Outcomes of COVID-19 Patients with ARDS  Who Received High Flow Nasal Oxygen in Medical Wards Outside Intensive Care Units Under Supervision of  Non-intensivists.

Özgür Kılıç; Ebru Kulucan; Yusuf Taha Gullu; Mehmet Polat; M Elmali; Esra Tanyel; Melda Dilek

Makale detayları

The Outcomes of COVID-19 Patients with ARDS Who Received High Flow Nasal Oxygen in Medical Wards Outside Intensive Care Units Under Supervision of Non-intensivists.

Yazarlar:

Özgür Kılıç | Ebru Kulucan | Yusuf Taha Gullu | Mehmet Polat | M Elmali | Esra Tanyel | Melda Dilek

Yayıncı:

Dokuz Eylul University

Ana Başlıklar:

Yoğun Bakım

Dergi:

Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi Vol.38 Issue 1, pp.1-10

Belge Tipi:

Makale

Yayın Tarihi:

5/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001321533

pISSN:

2602-3148

Anahtar kelimeler:

Özet:

 Objective: Efficacy of high flow nasal oxygen HFNO use in COVID-19 patients who developed ARDS in medical wards is poorly studied. We aimed to investigate whether use of HFNO in wards outside intensive care unit under supervision of non-intensivists has clinical effects on acute respiratory failure and whether it reduces ICU workload. Methods: COVID 19 patients who received HFNO therapy for ARDS in medical wards of an academic hospital were analyzed retrospectively. Primary outcome was the proportion of patients who were successfully weaned from HFNO. Results: 43 patients  32 male, median age 61 54-70 years were investigated. 14 33  patients weaned from HFNO and 29 67 patients failed HFNO and were tranferred to ICU. HFNO was applied in the group of HFNO with success with a median duration of 7 days 4-9 and in the failed group with median 3 days 2-5, p0.002. Median SpO2 after HFNO was higher in patients with HFNO success compared to with HFNO failure 95 94-97 vs 93 92-95, p0.015. In the group of HFNO with success, there were more hypocapnic patients than in the group of HFNO with failure 1929 66  vs 314 21; p0.015. Logistic regression analysis indicated that patients with hypocapnia had 9.8 times the odds of having HFNO failure compared with patients with normocapnia.No patient died among the patients succeded HFNO however 90 of patients who transferred to ICU died. Conclusion: Use of HFNO for COVID-19 patients with ARDS at a non-critical setting seemed to be beneficial in avoiding intubation and reducing workload of ICU. However due to high mortality rate among the HFNO failed group, it would be better to be used undersupervision of intensivists and by skilled team.

 Objective: Efficacy of high flow nasal oxygen HFNO use in COVID-19 patients who developed ARDS in medical wards is poorly studied. We aimed to investigate whether use of HFNO in wards outside intensive care unit under supervision of non-intensivists has clinical effects on acute respiratory failure and whether it reduces ICU workload. Methods: COVID 19 patients who received HFNO therapy for ARDS in medical wards of an academic hospital were analyzed retrospectively. Primary outcome was the proportion of patients who were successfully weaned from HFNO. Results: 43 patients  32 male, median age 61 54-70 years were investigated. 14 33  patients weaned from HFNO and 29 67 patients failed HFNO and were tranferred to ICU. HFNO was applied in the group of HFNO with success with a median duration of 7 days 4-9 and in the failed group with median 3 days 2-5, p0.002. Median SpO2 after HFNO was higher in patients with HFNO success compared to with HFNO failure 95 94-97 vs 93 92-95, p0.015. In the group of HFNO with success, there were more hypocapnic patients than in the group of HFNO with failure 1929 66  vs 314 21; p0.015. Logistic regression analysis indicated that patients with hypocapnia had 9.8 times the odds of having HFNO failure compared with patients with normocapnia.No patient died among the patients succeded HFNO however 90 of patients who transferred to ICU died. Conclusion: Use of HFNO for COVID-19 patients with ARDS at a non-critical setting seemed to be beneficial in avoiding intubation and reducing workload of ICU. However due to high mortality rate among the HFNO failed group, it would be better to be used undersupervision of intensivists and by skilled team.

 Objective: Efficacy of high flow nasal oxygen HFNO use in COVID-19 patients who developed ARDS in medical wards is poorly studied. We aimed to investigate whether use of HFNO in wards outside intensive care unit under supervision of non-intensivists has clinical effects on acute respiratory failure and whether it reduces ICU workload. Methods: COVID 19 patients who received HFNO therapy for ARDS in medical wards of an academic hospital were analyzed retrospectively. Primary outcome was the proportion of patients who were successfully weaned from HFNO. Results: 43 patients  32 male, median age 61 54-70 years were investigated. 14 33  patients weaned from HFNO and 29 67 patients failed HFNO and were tranferred to ICU. HFNO was applied in the group of HFNO with success with a median duration of 7 days 4-9 and in the failed group with median 3 days 2-5, p0.002. Median SpO2 after HFNO was higher in patients with HFNO success compared to with HFNO failure 95 94-97 vs 93 92-95, p0.015. In the group of HFNO with success, there were more hypocapnic patients than in the group of HFNO with failure 1929 66  vs 314 21; p0.015. Logistic regression analysis indicated that patients with hypocapnia had 9.8 times the odds of having HFNO failure compared with patients with normocapnia.No patient died among the patients succeded HFNO however 90 of patients who transferred to ICU died. Conclusion: Use of HFNO for COVID-19 patients with ARDS at a non-critical setting seemed to be beneficial in avoiding intubation and reducing workload of ICU. However due to high mortality rate among the HFNO failed group, it would be better to be used undersupervision of intensivists and by skilled team.

 Amaç: Servislerde ARDS gelişen COVID-19 hastalarında yüksek akışlı nazal oksijen HFNO kullanımının etkinliği yeterince araştırılmamıştır. HFNOnun yoğun bakım dışı servislerde yoğun bakım uzmanı olmayan gözetiminde kullanımının akut solunum yetmezliği üzerine klinik etkisinin olup olmadığını ve YBÜ iş yükünü azaltıp azaltmadığını araştırmayı amaçladık. Yöntemler: Bir akademik hastanenin servislerinde ARDS nedeniyle HFNO tedavisi alan COVID 19 hastaları retrospektif olarak incelendi. Birincil sonuç, HFNOdan başarıyla ayrılan hastaların oranıydı. HFNOnun başarısızlığı, yoğun bakım ihtiyacının ortaya çıkması olarak tanımlandı. Bulgular: 43 hasta 32 erkek, medyan yaş 61 54-70 yıl incelendi. 14 33 hasta HFNOdan ayrıldı. 29 67 hasta HFNOda başarısız oldu ve yoğun bakım ünitesine nakledildi. HFNO grubunda ortanca 7 gün 4-9 başarı ile, başarısız grupta ortanca 3 gün 2-5 HFNO uygulandı, p0,002. HFNO sonrası medyan SpO2, HFNO başarısı olan hastalarda HFNO başarısızlığına kıyasla daha yüksekti 95 94-97 ve 93 92-95, p0.015. Başarılı HFNO grubunda, başarısız HFNO grubuna göre daha fazla hipokapnik hasta vardı 1929 66 - 314 21; p0.015. Lojistik regresyon analizi, hipokapnisi olan hastaların normokapnisi olan hastalara kıyasla 9.8 kat daha fazla HFNO yetmezliğine sahip olduğunu gösterdi. HFNOyu başaran hastalar arasında hiçbir hasta ölmedi, ancak yoğun bakım ünitesine nakledilen hastaların 90ı öldü. Sonuç: ARDSli COVID-19 hastalarında servis ortamında HFNO kullanımı, entübasyondan kaçınma ve yoğun bakım ünitesinin iş yükünü azaltmada faydalı görünüyordu. Ancak HFNO başarısızlığı olan grupta mortalite oranının yüksek olması nedeniyle yoğun bakım uzmanlarının gözetiminde ve yetenekli ekipler tarafından kullanılması daha doğru olacaktır.

Makale detayları

The Outcomes of COVID-19 Patients with ARDS Who Received High Flow Nasal Oxygen in Medical Wards Outside Intensive Care Units Under Supervision of Non-intensivists.

Yazarlar:

Özgür Kılıç | Ebru Kulucan | Yusuf Taha Gullu | Mehmet Polat | M Elmali | Esra Tanyel | Melda Dilek

Yayıncı:

Dokuz Eylul University

Ana Başlıklar:

Yoğun Bakım

Dergi:

Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi Vol.38 Issue 1, pp.1-10

Belge Tipi:

Makale

Yayın Tarihi:

5/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001321533

pISSN:

2602-3148

COVID-19

High Flow Nasal Oxygenation

ARDS

medical ward

ICU workloadCOVID-19

Yüksek Akışlı Nazal Oksijenasyon

ARDS

yoğun bakım dışı servis

yoğun bakım iş yükü

Sayı

Makale detayları

Yazarlar: Özgür Kılıç | Ebru Kulucan | Yusuf Taha Gullu | Mehmet Polat | M Elmali | Esra Tanyel | Melda Dilek

Yayıncı: Dokuz Eylul University

Ana Başlıklar: Yoğun Bakım

Dergi: Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi Vol.38 Issue 1, pp.1-10

Belge Tipi: Makale

Yayın Tarihi: 5/2024

Belge Dili: İngilizce

Document ID (Org No.): 2001321533

pISSN: 2602-3148

Sayı

Yazarlar:

Özgür Kılıç | Ebru Kulucan | Yusuf Taha Gullu | Mehmet Polat | M Elmali | Esra Tanyel | Melda Dilek

Yayıncı:

Dokuz Eylul University

Ana Başlıklar:

Yoğun Bakım

Dergi:

Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi Vol.38 Issue 1, pp.1-10

Belge Tipi:

Makale

Yayın Tarihi:

5/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001321533

pISSN:

2602-3148