A Retrospective Analysis of COVID-19 ARDS Patients Successfully Extubated to High Flow Nasal Cannula Oxygen Therapy

Abstract

\n Background\n\nCoronavirus disease- 2019 (COVID-19) related to acute respiratory distress syndrome (ARDS) caused by the highly infectious SARS-CoV-2 novel coronavirus is a major cause of death during the pandemic period. Here we aim to present the retrospective data analysis of extubation success to High Flow Nasal Cannula Oxygen Therapy (HFNO) in COVID-19 ARDS patients.\nMethods\n\nThe data of 22 laboratory-confirmed COVID-19 ARDS patients who were extubated to HFNO therapy at an intensive care unit (ICU) were analyzed. Respiratory variables as well as demographic characteristics were collected on admission. The mechanical ventilation volumes and pressures together with blood gas measurements were recorded during the intubation period. HFNO flow rate, FiO2, and oxygenation variables were collected 5 consecutive days after extubation. The reintubation rate within the 5 days following planned extubation, duration of ICU stay, and mortality were recorded.\nResults\n\nAmong 22 patients, 16 were male (72.7%) and the mean age was 69.9\u2009±\u200913,2 years with the highest comorbidity being hypertension (59.1%). The duration between symptom initiation to ICU admission was 6.5\u2009±\u20097,9 days where nearly all patients were intubated on the same day. Twenty patients were successfully extubated to HFNO and 2 patients experienced reintubation. The mean duration of HFNO treatment was 4.8\u2009±\u20093.6 days and the length of ICU stay was 17.4\u2009±\u20096 days. The ICU mortality ratio of this complete data was 13.6% (3/22).\nConclusion\n\nAmong high-risk ARDS COVID-19 patients who have undergone extubation, HFNO therapy should be considered for preventing reintubation and post-extubation respiratory failure.