Surgical mask on top of high-flow nasal cannula improves oxygenation in critically ill COVID-19 patients with hypoxemic respiratory failure
Open Access
- 29 September 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Annals of Intensive Care
- Vol. 10 (1), 1-7
- https://doi.org/10.1186/s13613-020-00744-x
Abstract
Critically ill patients admitted in ICU because of COVID-19 infection display severe hypoxemic respiratory failure. The Surviving Sepsis Campaign recommends oxygenation through high-flow nasal cannula over non-invasive ventilation. The primary outcome of our study was to evaluate the effect of the addition of a surgical mask on a high-flow nasal cannula system on oxygenation parameters in hypoxemic COVID-19 patients admitted in ICU who do not require urgent intubation. The secondary outcomes were relevant changes in PaCO2 associated with clinical modifications and patient’s feelings. We prospectively assessed 21 patients admitted in our mixed Intensive Care Unit of the Cliniques Universitaires Saint Luc. While FiO2 was unchanged, we demonstrate a significant increase of PaO2 (from 59 (± 6), to 79 mmHg (± 16), p < 0.001), PaO2/FiO2 from 83 (± 22), to 111 (± 38), p < 0.001) and SaO2 (from 91% (± 1.5), to 94% (± 1.6), p < 0.001), while the patients were under the surgical mask. The SpO2 returned to pre-treatment values when the surgical mask was removed confirming the effect of the device rather than a spontaneous positive evolution. A surgical mask placed on patient’s face already treated by a High-flow nasal cannula device improves COVID-19 patient’s oxygenation admitted in Intensive Care Unit for severe hypoxemic respiratory failure without any clinically relevant side.Keywords
This publication has 18 references indexed in Scilit:
- Clinical Evidence of Nasal High-Flow Therapy in Chronic Obstructive Pulmonary Disease PatientsRespiration, 2020
- Assessment of the potential for pathogen dispersal during high-flow nasal therapyJournal of Hospital Infection, 2019
- The Double-Trunk Mask Improves Oxygenation During High-Flow Nasal Cannula Therapy for Acute Hypoxemic Respiratory FailureRespiratory Care, 2019
- High flow nasal cannula compared with conventional oxygen therapy for acute hypoxemic respiratory failure: a systematic review and meta-analysisIntensive Care Medicine, 2019
- Exhaled air dispersion during high-flow nasal cannula therapy versus CPAP via different masksEuropean Respiratory Journal, 2019
- Comparison of high-flow nasal cannula versus oxygen face mask for environmental bacterial contamination in critically ill pneumonia patients: a randomized controlled crossover trialJournal of Hospital Infection, 2019
- High flow nasal cannula versus conventional oxygen therapy and non-invasive ventilation in adults with acute hypoxemic respiratory failure: A systematic reviewRespiratory Medicine, 2016
- High-Flow Nasal Cannula Oxygen Therapy in Adults: Physiological Benefits, Indication, Clinical Benefits, and Adverse EffectsRespiratory Care, 2016
- High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory FailureThe New England Journal of Medicine, 2015
- Airflow and droplet spreading around oxygen masks: A simulation model for infection control researchAmerican Journal of Infection Control, 2007