Servicio de Medicina Interna, Hospital HLA Inmaculada, Granada, España.
Servicio de Medicina Interna, Hospital HLA Inmaculada, Granada, España.
Med Clin (Barc). 2022 Jun 10;158(11):540-542. doi: 10.1016/j.medcli.2021.05.015. Epub 2021 Jun 16.
Severe COVID-19 is associated with hypoxemic bilateral pneumonia that leads to mechanical ventilation in a considerable proportion of patients. To the best of our knowledge, there are no recommendations about the best time to initiate high flow nasal cannula (HFNC).
Retrospective study of all patients admitted for COVID-19 pneumonia who required HNFO between March 2020 and February 2021. Patients were grouped in early HNFC or late HNFC, according to the modified Kirby index.
53 patients were included. Forty-four of them were included in the early HFNC and 9 in late HNFC. There were no statistically significant clinical-epidemiological differences. Early use of HFNC was associated with a decrease in the need for intubation (29.5 vs. 66.6%, p = 0.044), hospital stay (18.8 d vs. 36 d, p = 0.022) and mortality (22.7 vs. 55.5%, p = 0.061).
Early HFNC use is associated with a decrease in the need for intubation, mortality and overall hospital stay.
严重的 COVID-19 与低氧血症性双侧肺炎有关，这会导致相当一部分患者需要进行机械通气。据我们所知，目前尚无关于启动高流量鼻导管（HFNC）最佳时机的建议。
这是一项回顾性研究，纳入了所有因 COVID-19 肺炎而需要 HFNC 的患者，研究时间为 2020 年 3 月至 2021 年 2 月。根据改良 Kirby 指数，将患者分为早期 HFNC 组和晚期 HFNC 组。
共纳入 53 例患者，其中 44 例患者接受早期 HFNC，9 例患者接受晚期 HFNC。两组在临床流行病学方面无统计学差异。早期使用 HFNC 与降低插管需求（29.5% vs. 66.6%，p = 0.044）、住院时间（18.8 天 vs. 36 天，p = 0.022）和死亡率（22.7% vs. 55.5%，p = 0.061）相关。
早期使用 HFNC 与降低插管需求、死亡率和总住院时间相关。
