High-flow nasal oxygen therapy decrease the risk of mortality and the use of invasive mechanical ventilation in patients with severe SARS-CoV-2 pneumonia? A retrospective and comparative study of 265 cases

Rajae Alkouh; Abdelilah El Rhalete; Merbouh Manal; El Aidouni Ghizlane; Berrichi Samia; Taouihar Salma; Fatima Zahra Aftiss; Bkiyar Houssam; Abda Naima; Housni Brahim

doi:10.1016/j.amsu.2021.103230

High-flow nasal oxygen therapy decrease the risk of mortality and the use of invasive mechanical ventilation in patients with severe SARS-CoV-2 pneumonia? A retrospective and comparative study of 265 cases

Ann Med Surg (Lond). 2022 Feb:74:103230. doi: 10.1016/j.amsu.2021.103230. Epub 2022 Jan 4.

Authors

Rajae Alkouh^{1

2}, Abdelilah El Rhalete^{1

2}, Merbouh Manal^{1

2}, El Aidouni Ghizlane^{1

2}, Berrichi Samia^{1

2}, Taouihar Salma^{1

2}, Fatima Zahra Aftiss^{1

2}, Bkiyar Houssam^{1

2

3}, Abda Naima^{1

2

3}, Housni Brahim^{1

2

4}

Affiliations

¹ Department of Intensive Care Unit, Mohammed VI University Hospital, Oujda, Morocco.
² Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco.
³ Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, LERCSP, Oujda, Morocco.
⁴ Mohammed First University Oujda, FMP Oujda, LAMCESM, Oujda, Morocco.

Abstract

Introduction: Corona virus disease (Covid-19) affects the airways and induces pulmonary lesions, patients with this disease require oxygen therapy as the disease progresses. Several oxygenation options have been used, l'HFNO had showed beneficial effects.

The objective of this study: To evaluate the efficacy of high-flow nasal oxygen HFNO versus non-invasive ventilation in COVID-19.

Methods: This is a retrospective and comparative study conducted over a period of 10 months from March 2020 to December 2020 and involving 600 patients hospitalized in the intensive care unit of the CHU Mohammed VI of Oujda for the management of acute respiratory failure caused by COVID-19.

Results: Out of 600 patients with acute respiratory failure, 265 patients were included in the analyses. 162 (61.10%) patients were treated with HFNO, the intubation rate was 49.7% (80 patients out of 162) of which 63 died intubated (78.8%). Concerning the 82 non-intubated patients, only 16 died (19.8%).The total number of patients who received NIV was 71 (26.8%), 33 (46.5%) required mechanical ventilation. In-hospital mortality in patients treated with NIV was 100%.The difference in mortality outcome between the two groups was significantly (P < 0.0001) reduced in HFNO.

Conclusions: Treatment with high-flow oxygen improved survival in patients with acute hypoxemic respiratory failure compared with noninvasive ventilation, although no difference was observed in intubation rate.

Keywords: Acute respiratory failure; COVID-19; High-flow nasal oxygen therapy; Intensive care unit; Non-invasive ventilation.