Abstract No.: ABS0636: Role of the high-flow nasal cannula as a treatment modality in patients with hypoxemic respiratory failure because of COVID 19 – A prospective observational study

Abstract

Background and Aims:The high-flow nasal cannula (HFNC), a high-flow oxygen-generating device, delivers targeted FiO2 and reduces the dead space with adequate positive end-expiratory pressure delivery, improving the ventilatory efficiency. We aimed to establish the efficacy of HFNC in the management of hypoxemic respiratoryfailure because of coronavirus disease 19 (COVID-19) using ROX index [(SpO2/FiO2)/RR].Methods:A total of 65 COVID-19-positive patients admitted in the intensive care unit (ICU) were selected based on whether SpO2 <90% with laboured breathing and not improving on a non-re-breathing mask at >15 l/min of oxygen. Patients were observed every 4 hours with respect to ROX index, vital and laboratory parameters, arterial blood pressure analysis, and drug treatment, depending on which patients were either weaned off or put on non-invasive ventilation (NIV)/invasive ventilation. Thus, ROX index was used to evaluate the efficacy of using HFNC in the management of hypoxemic respiratory failure because of COVID-19.Results:The mean baseline ROX index of all 65 patients at the time of admission in ICU was 3.76 ± 0.54. The mean ROX index of all 65 patients at 2, 6, and 12 hours of being put on HFNC was 4.79 ± 0.79, 4.86 ± 0.8, and 5.04 ± 0.85, respectively. Out of 65, 14 patients who experienced HFNC failure had a mean ROX index of 3.40 ± 0.76 before being put on NIV/invasive ventilation at an average median of 48 hours (24–114 hours).Conclusion:ROX index can be effectively correlated with the efficacy of HFNC in the management of hypoxemic respiratory failure because of COVID-19, thus decreasing the need of NIV or invasive ventilation.