High-flow Nasal Cannula therapy: A feasible treatment for vulnerable elderly COVID-19 patients in the wards

Job van Steenkiste; Michael C. van Herwerden; Dolf Weller; Christiaan J. van den Bout; Rikje Ruiter; Jan G. den Hollander; Rachida el Moussaoui; Gert T. Verhoeven; Charlotte van Noord; Marinus A. van den Dorpel

doi:10.1016/j.hrtlng.2021.04.008

High-flow Nasal Cannula therapy: A feasible treatment for vulnerable elderly COVID-19 patients in the wards

Job van Steenkiste^*, Michael C. van Herwerden, Dolf Weller, Christiaan J. van den Bout, Rikje Ruiter, Jan G. den Hollander, Rachida el Moussaoui, Gert T. Verhoeven, Charlotte van Noord, Marinus A. van den Dorpel

^*Corresponding author for this work

Epidemiology

Research output: Contribution to journal › Article › Academic › peer-review

13 Citations (Scopus)

Abstract

Background: Invasive mechanical ventilation is the treatment of choice in COVID-19 patients when hypoxemia persists, despite maximum conventional oxygen administration. Some frail patients with severe hypoxemic respiratory failure are deemed not eligible for invasive mechanical ventilation. Objectives: To investigate whether High-flow nasal cannula (HFNC) in the wards could serve as a rescue therapy in these frail patients. Methods: This retrospective cohort study included frail COVID-19 patients admitted to the hospital between March 9th and May 1st 2020. HFNC therapy was started in the wards. The primary endpoint was the survival rate at hospital discharge. Results: Thirty-two patients with a median age of 79.0 years (74.5–83.0) and a Clinical Frailty Score of 4 out of 9 (3–6) were included. Only 6% reported HFNC tolerability issues. The overall survival rate was 25% at hospital discharge. Conclusions: This study suggests that, when preferred, HFNC in the wards could be a potential rescue therapy for respiratory failure in vulnerable COVID-19 patients.

Original language	English
Pages (from-to)	654-659
Number of pages	6
Journal	Heart and Lung
Volume	50
Issue number	5
DOIs	https://doi.org/10.1016/j.hrtlng.2021.04.008
Publication status	Published - 1 Sept 2021

Bibliographical note

Funding Information:
This study was approved by the Hospitals Medical Ethical Committee (Medical Research Ethics Committees United, reference L2019023), application number W20.081. The datasets that were used and/or analysed during the current study, are available from the corresponding author by a reasonable request. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. JS and MvH invented the study and were responsible for the integrity of the database. All authors were responsible for the treatment of patients, collecting clinical and additional data and for writing the manuscript. All authors approved the final version after reviewing, We thank Geeke van Waverijn for data extraction and preparation. We thank Evelien Oostdijk and Rob Zwinkels for the critical reading of the manuscript.

Publisher Copyright:
© 2021 Elsevier Inc.

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10.1016/j.hrtlng.2021.04.008

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van Steenkiste, J., van Herwerden, M. C., Weller, D., van den Bout, C. J., Ruiter, R., den Hollander, J. G., el Moussaoui, R., Verhoeven, G. T., van Noord, C., & van den Dorpel, M. A. (2021). High-flow Nasal Cannula therapy: A feasible treatment for vulnerable elderly COVID-19 patients in the wards. Heart and Lung, 50(5), 654-659. https://doi.org/10.1016/j.hrtlng.2021.04.008

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title = "High-flow Nasal Cannula therapy: A feasible treatment for vulnerable elderly COVID-19 patients in the wards",

abstract = "Background: Invasive mechanical ventilation is the treatment of choice in COVID-19 patients when hypoxemia persists, despite maximum conventional oxygen administration. Some frail patients with severe hypoxemic respiratory failure are deemed not eligible for invasive mechanical ventilation. Objectives: To investigate whether High-flow nasal cannula (HFNC) in the wards could serve as a rescue therapy in these frail patients. Methods: This retrospective cohort study included frail COVID-19 patients admitted to the hospital between March 9th and May 1st 2020. HFNC therapy was started in the wards. The primary endpoint was the survival rate at hospital discharge. Results: Thirty-two patients with a median age of 79.0 years (74.5–83.0) and a Clinical Frailty Score of 4 out of 9 (3–6) were included. Only 6% reported HFNC tolerability issues. The overall survival rate was 25% at hospital discharge. Conclusions: This study suggests that, when preferred, HFNC in the wards could be a potential rescue therapy for respiratory failure in vulnerable COVID-19 patients.",

author = "{van Steenkiste}, Job and {van Herwerden}, {Michael C.} and Dolf Weller and {van den Bout}, {Christiaan J.} and Rikje Ruiter and {den Hollander}, {Jan G.} and {el Moussaoui}, Rachida and Verhoeven, {Gert T.} and {van Noord}, Charlotte and {van den Dorpel}, {Marinus A.}",

note = "Funding Information: This study was approved by the Hospitals Medical Ethical Committee (Medical Research Ethics Committees United, reference L2019023), application number W20.081. The datasets that were used and/or analysed during the current study, are available from the corresponding author by a reasonable request. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. JS and MvH invented the study and were responsible for the integrity of the database. All authors were responsible for the treatment of patients, collecting clinical and additional data and for writing the manuscript. All authors approved the final version after reviewing, We thank Geeke van Waverijn for data extraction and preparation. We thank Evelien Oostdijk and Rob Zwinkels for the critical reading of the manuscript. Publisher Copyright: {\textcopyright} 2021 Elsevier Inc.",

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doi = "10.1016/j.hrtlng.2021.04.008",

language = "English",

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T1 - High-flow Nasal Cannula therapy

T2 - A feasible treatment for vulnerable elderly COVID-19 patients in the wards

AU - van Steenkiste, Job

AU - van Herwerden, Michael C.

AU - Weller, Dolf

AU - van den Bout, Christiaan J.

AU - Ruiter, Rikje

AU - den Hollander, Jan G.

AU - el Moussaoui, Rachida

AU - Verhoeven, Gert T.

AU - van Noord, Charlotte

AU - van den Dorpel, Marinus A.

N1 - Funding Information: This study was approved by the Hospitals Medical Ethical Committee (Medical Research Ethics Committees United, reference L2019023), application number W20.081. The datasets that were used and/or analysed during the current study, are available from the corresponding author by a reasonable request. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. JS and MvH invented the study and were responsible for the integrity of the database. All authors were responsible for the treatment of patients, collecting clinical and additional data and for writing the manuscript. All authors approved the final version after reviewing, We thank Geeke van Waverijn for data extraction and preparation. We thank Evelien Oostdijk and Rob Zwinkels for the critical reading of the manuscript. Publisher Copyright: © 2021 Elsevier Inc.

PY - 2021/9/1

Y1 - 2021/9/1

N2 - Background: Invasive mechanical ventilation is the treatment of choice in COVID-19 patients when hypoxemia persists, despite maximum conventional oxygen administration. Some frail patients with severe hypoxemic respiratory failure are deemed not eligible for invasive mechanical ventilation. Objectives: To investigate whether High-flow nasal cannula (HFNC) in the wards could serve as a rescue therapy in these frail patients. Methods: This retrospective cohort study included frail COVID-19 patients admitted to the hospital between March 9th and May 1st 2020. HFNC therapy was started in the wards. The primary endpoint was the survival rate at hospital discharge. Results: Thirty-two patients with a median age of 79.0 years (74.5–83.0) and a Clinical Frailty Score of 4 out of 9 (3–6) were included. Only 6% reported HFNC tolerability issues. The overall survival rate was 25% at hospital discharge. Conclusions: This study suggests that, when preferred, HFNC in the wards could be a potential rescue therapy for respiratory failure in vulnerable COVID-19 patients.

AB - Background: Invasive mechanical ventilation is the treatment of choice in COVID-19 patients when hypoxemia persists, despite maximum conventional oxygen administration. Some frail patients with severe hypoxemic respiratory failure are deemed not eligible for invasive mechanical ventilation. Objectives: To investigate whether High-flow nasal cannula (HFNC) in the wards could serve as a rescue therapy in these frail patients. Methods: This retrospective cohort study included frail COVID-19 patients admitted to the hospital between March 9th and May 1st 2020. HFNC therapy was started in the wards. The primary endpoint was the survival rate at hospital discharge. Results: Thirty-two patients with a median age of 79.0 years (74.5–83.0) and a Clinical Frailty Score of 4 out of 9 (3–6) were included. Only 6% reported HFNC tolerability issues. The overall survival rate was 25% at hospital discharge. Conclusions: This study suggests that, when preferred, HFNC in the wards could be a potential rescue therapy for respiratory failure in vulnerable COVID-19 patients.

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ER -

High-flow Nasal Cannula therapy: A feasible treatment for vulnerable elderly COVID-19 patients in the wards

Abstract

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