Background:

Ventilatory support is considered first line for the treatment of acute respiratory failure. Better understanding the relationship between the use of high flow and outcome in patients with COVID-19 is relevant as it has emerged as an alternative to orotracheal intubation.

Objective:

To determine the effect of high-flow nasal cannula on hospital stay and mortality of patients with SARS-CoV-2 infection and hypoxemic respiratory failure during the years 2020 and 2021 in a national university hospital.

Methods:

Retrospective cohort study was carried out between March 2020 and February 2021, of patients with severe SARS-CoV-2 pneumonia and ventilatory failure. The High Flow Nasal Cannula was evaluated compared to conventional mechanical ventilation. Propensity score was used for stay, mortality and secondary outcomes (bloodstream infection, acute renal failure, among others). Finally, 30-day mortality and live discharge were evaluated using the Poisson model.

Results:

160 patients were analyzed (40 with Cannula and 120 with Orotracheal Intubation), 66,9 % being men and average age 63,8 years. 81 patients (50,6 %) died in the first 30 days of hospitalization. After adjustment, no association was found with mortality (RaIR 1,13, 95 % CI: 0,93-1,38), but with shorter stay, frequency of Orotracheal Intubation and acute kidney injury.

Conclusion:

The group of patients who received a high-flow nasal cannula showed a lower frequency of invasive mechanical ventilation, hospital stay and acute kidney injury not previously described, although no reduction in mortality was found.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )