Abstract
Aim: In Coronavirus disease 2019 (COVID-19)-related respiratory failure, high-flow nasal oxygen (HFNO) therapy may delay invasive ventilation. The respiratory rate oxygenation (ROX) and modified ROX (mROX) indices, which can predict the need for invasive ventilation, can also be used in patients with COVID-19 with respiratory failure. The aim of the study was to verify the effectiveness of ROX and mROX to predict entubation need in HFNO therapy patients in intensive care unit. Material and Methods: This retrospective study included 41 patients in the final evaluation. Results: The overall mortality of patients with similar demographic and laboratory data was 60,97%. Invasive ventilation was required in 27 patients. The cutoff values for prediction of intubation for ROX and mROX at 6 h were determined as 4,95 and 6,01. Conclusion: These indices can predict the need for invasive ventilation during the follow-up of COVİD 19 patients who under go HFNO and can help prevent adverse outcomes.
Highlights
High-flow nasal oxygen (HFNO), a humidified and heated oxygen-rich gas, is administered in patients by special nasal high-flow cannulas
In our intensive care unit, 14 (34.14%) of our 41 patients who underwent HFNO due to respiratory failure related to polymerase chain reaction (PCR)-positive COVID-19 pneumonia did not require invasive mechanical ventilation
There are limited data regarding the use of HFNO in respiratory failure due to COVID-19 pneumonia, there are studies indicating its potential reducing the need for invasive ventilation in patients with COVID-19 [3,10]
Summary
High-flow nasal oxygen (HFNO), a humidified and heated oxygen-rich gas, is administered in patients by special nasal high-flow cannulas. The initial message from the Chinese medical teams was to intubate Coronavirus disease 2019 (COVID-19) patients early, somewhere around a 5-6 liter by nasal prong O2 requirement. Despite HFNO large swings in intra-pleural pressure may result in self-inflicted lung injury and worsen the disease process. For this reason it has been stated that delayed intubation and mechanical ventilation support in patients with COVID-19 undergoing HFNO may increase the mortality rate [5]
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