The use of high‐flow nasal oxygen in COVID‐19

The authors proposed that the lower mortality observed in the HFNO group resulted from the cumulative benefit of a lower tracheal intubation rate in those patients with severe hypoxaemia (PaO2:FIO2 ≤ 200 mmHg), and a slightly lower mortality among intubated patients who were initially treated with H...

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Bibliographic Details
Published in:Anaesthesia 2020-07, Vol.75 (7), p.843-847
Main Authors: Lyons, C., Callaghan, M.
Format: Article
Language:English
Subjects:
aerosolisation
Betacoronavirus
Coronavirus Infections - complications
COVID-19
high‐flow nasal oxygen
Humans
Noninvasive Ventilation - methods
Oxygen Inhalation Therapy - methods
Pandemics
Pneumonia, Viral - complications
respiratory failure
Respiratory Insufficiency - etiology
Respiratory Insufficiency - therapy
SARS-CoV-2
tracheal intubation
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Summary:The authors proposed that the lower mortality observed in the HFNO group resulted from the cumulative benefit of a lower tracheal intubation rate in those patients with severe hypoxaemia (PaO2:FIO2 ≤ 200 mmHg), and a slightly lower mortality among intubated patients who were initially treated with HFNO. Rochwerg et al. published a systematic review and meta‐analysis comparing HFNO with conventional oxygen therapy in patients with acute hypoxaemic respiratory failure 2. No difference in mortality was observed in patients treated with HFNO (relative risk (RR) 0.94, 95%CI 0.67–1.31) compared with conventional oxygen therapy. [...]of writing (27 March, 2020), joint guidance issued by the Faculty of Intensive Care Medicine, Intensive Care Society, Association of Anaesthetists and Royal College of Anaesthetists states that “high‐flow nasal oxygen or similar devices should be avoided,” remarking that there is “no survival benefit compared to conventional oxygen therapy, and the risk of environmental viral contamination may be higher” 3.
ISSN:0003-2409
1365-2044
DOI:10.1111/anae.15073