Oxigenoterapia de alto flujo, ¿un nuevo horizonte en el tratamiento de la insuficiencia respiratoria aguda?

Abstract

The goal of the study is to analyze the impact and the results of the application of high flow oxygen therapy in an intensive care unit of a tertiary hospital. Materials and methodsWe perform a retrospective study of all patients which has been treated with the high flow oxygen therapy between May 2013 and April 2016. ResultsThe study includes 174 patients, age 57.81, 102 men. Severity indexes: SOFA 8.17, APACHE II 19.43 and SAPS II 48.66. Average stay 14 days and mortality rate 22.4%.The 56.9% of patients, who required high flow oxygen therapy, used mechanical ventilation before or after and 43.1% of the patients didn’t require.The group of patients which needed mechanical ventilation had higher mortality (P<.0001). The mortality rate is higher due to retardation of the intubation, after the high flow oxygen therapy failure. The patients intubated the first 48 h after the high flow oxygen therapy failure have a mortality of 44% vs. the 55% after 48 h (P=.32). There are significant differences in the mortality regarding the type of patient. It is very probable that the most benefit group is the one with severe respiratory deficiency in respiratory cause setting and hypoxic decompensation cause, but further studies are required to confirm this data. ConclusionsThe high flow nasal cannula oxygen therapy may avoid the use of mechanical ventilation. However, the retardation of the orotracheal intubation after high flow therapy failure, increases the rate of mortality.