High-Flow Nasal Cannula Failure Odds Is Largely Independent of Duration of Use in COVID-19
Résumé
A central question in coronavirus disease 2019 (COVID-19)-associated hypoxemia management remains how to optimally provide and escalate respiratory support. Numerous studies have investigated the potential impact of “early intubation;” together, these suggest there is neither benefit nor harm with this approach (1). However, as observational studies without protocols for when to initiate invasive mechanical ventilation (IMV), all are likely subject to indication bias. Clinicians are left, therefore, with little evidence on which to base decisions about when and in whom IMV initiation is appropriate. In this study, we sought to evaluate the outcomes of patients supported with high-flow nasal cannula (HFNC) for increasing periods of time. We hypothesized that after a certain amount of time on HFNC, the odds of HFNC failure (defined as intubation or death without intubation by Study Day 28) would increase. Such results may assist clinicians and patients in decisions about the use and timing of IMV.
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