High flow nasal cannula (HFNC) is a popular treatment method for hypoxemic patients as it provides accurate oxygen concentration via a specially designed nasal cannula. This treatment results in decreased dead space ventilation through the application of a variable, unknown level of PEEP. Heated, humidified oxygen provided through a HFNC offers an advantage over mechanical ventilation due to its improved comfort, oxygenation, and lung mechanics and has been associated with lower mortality and risk of intubation for patients. Though there have been concerns over aerosol generation in treating COVID-19 patients, the risk of nosocomial transmission of SARS Co-V2 is not increased with HFNC. The purpose of this study was to determine if high-flow nasal cannulas can prevent the intubation of hypoxemic, SARS Co-V2 patients and which comorbidities correlate to a higher success in HFNC treatment. This retrospective, clinical study was conducted at Massachusetts General Hospital (Boston, MA) using the clinical data of COVID-19 ARDS patients in the ICU. Data was collected beginning from September, 2020 to March, 2021. APACHE, SOFA, and ROX scores were recorded for each patient as well as presence of comorbidities such as diabetes, smoking history, etc. The results of this study show that certain populations benefit from HFNC treatment and results will be used to contribute to scientific and clinical knowledge about the optimal treatment of hypoxic COVID-19 patients.
Additional non-Northeastern affiliates: Bijan Fakhr Safaee MD, Eduardo Diaz Delgado BS, Carlo Valsecchi MD, Lorenzo Berra MD, Robert Kacmarek PhD,RRT