García-Pereña Laura, Ramos Sesma Violeta, Tornero Divieso María Lucía, Lluna Carrascosa Alfonso, Velasco Fuentes Sara, Parra-Ruiz Jorge
Servicio de Medicina Interna, Hospital HLA Inmaculada, Granada, Spain.
Med Clin (Engl Ed). 2022 Jun 10;158(11):540-542. doi: 10.1016/j.medcle.2021.05.024. Epub 2022 May 25.
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.
重症新型冠状病毒肺炎（COVID-19）与低氧性双侧肺炎相关，相当一部分患者因此需要机械通气。据我们所知，目前尚无关于启动高流量鼻导管（HFNC）最佳时机的相关建议。
对2020年3月至2021年2月期间因COVID-19肺炎入院且需要高流量鼻导管吸氧（HNFO）的所有患者进行回顾性研究。根据改良柯比指数，将患者分为早期HFNC组或晚期HFNC组。
共纳入53例患者。其中44例纳入早期HFNC组，9例纳入晚期HFNC组。临床流行病学方面无统计学显著差异。早期使用HFNC与插管需求减少（29.5%对66.6%，p = 0.044）、住院时间缩短（18.8天对36天，p = 0.02）和死亡率降低（22.7%对55.5%，p = 0.061）相关。
早期使用HFNC与插管需求、死亡率及总体住院时间的降低相关。
