Respiratory Care |

High Flow Nasal Cannula Oxygen in Acute Respiratory Failure; Effectiveness and Predictors of Failure FREE TO VIEW

Myung-Goo Lee*, MD; So Young Park, MD; Chang Youl Lee, MD
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Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea

Chest. 2012;142(4_MeetingAbstracts):951A. doi:10.1378/chest.1388694
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SESSION TYPE: Respiratory Support Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: To determine the effectiveness of high flow nasal cannula (HFNC), and the factors predicting failure of HFNC in acute respiratory failure

METHODS: We retrospectively evaluated the patients with acute respiratory failure who required HFNC at Hallym University Chuncheon Sacred Hospital between August 2011 and January 2012.

RESULTS: 33 patients were included in the study. Their median age was 73.4 years (49-89). Majority of the patients were male (22 patients, 67%). The most common cause of acute respiratory failure were pneumonia followed by COPD acute exacerbation, acute pulmonary edema due to congestive heart failure, cancer progression, and fibrotic lung disease. The hospital mortality was 24% in patients with HFNC. 5 patients refused endotracheal intubation. 23 out of 28 patients (82%) could be avoided from potential endotracheal intubation. In the unadjusted model, APACHE II score (P=0.04), higher BNP (>500 pg/ml) (P=0.03) and higher respiratory rate (respiratory rate > 30) (P=0.04) were associated with HFNC failure. However, in the adjusted model, only higher respiratory rate (P=0.04) was associated with HFNC failure [P=0.04, OR 3.36].

CONCLUSIONS: HFNC has beneficial effect on clinical sign and oxygenation in patients with acute respiratory failure. Predictors of high flow nasal cannula failure might be used to guide decisions regarding intubation in hypoxic respiratory failure.

CLINICAL IMPLICATIONS: Tachycardia more than 30 may predict outcome of HFNC treatment. More predictors has to be elucidated.

DISCLOSURE: The following authors have nothing to disclose: Myung-Goo Lee, So Young Park, Chang Youl Lee

No Product/Research Disclosure Information

Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea




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