Desenlaces clínicos en pacientes con diagnóstico de neumonía relacionada con SARS-CoV-2 manejados con cánula de alto flujo, una experiencia clínica. (Estudio CANALF)

Abstract

IntroductionThe inclusion of non-invasive ventilatory support systems in the management of ARDS in adults during the current pandemic, has been a lifeline given the lack of resources in the current international health situation. Systems such as the high flow nasal cannula have proven not to be just a temporary ventilatory system while awaiting invasive mechanical ventilation, on the contrary it has been shown that the high flow nasal cannula is an effective therapy tool in ARDS. ObjectiveTo provide an easy guideline for the management of high-flow cannulas in hospitalized patients with severe pneumonia due to ATS criteria secondary to SARS COV2-COVID 19. Materials and methodsThis is a prospective, single-centre observational study, including 59 patients, all with a diagnosis of SARS-CoV-2-related pneumonia between January and April 2021. The patients were initially managed in an intermediate care unit with high nasal cannula flow (HFNC). ResultsWe were able to show that there is a statistically significant correlation between age > 65 years and respiratory rate ≥28 and mortality; likewise, between age > 50 years, NEWS > 6 and again a respiratory rate ≥28 with treatment failure. ConclusionsHFNC in respiratory failure related to coronavirus disease 2019 should become a viable management alternative, particularly in settings with limited access to intensive care unit resources, taking the indications into account and recognizing that a high percentage of patients who receive it can be successfully weaned without the need for invasive mechanical ventilation.