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Identifier

000438843

Title

Ενδείξεις εφαρμογής και αποτελεσματικότητα της ρινικής κάνουλας υψηλής ροής(high-flow nasal cannula) σε ασθενείς ΜΕΘ με οξεία αναπνευστική ανεπάρκεια

Alternative Title

Indications and effectiveness of high-flow nasal cannula in ICU patients with acute respiratory failure

Author

Κωνσταντινίδη, Αγγελική

Thesis advisor

Κονδύλη, Ευμορφία

Reviewer

Βαπορίδη, Αικατερίνη
Ηλία, Σταυρούλα

Abstract

Background The use of High Flow Nasal Cannula (HFNC) for the treatment of respiratory failure has been widely studied. The application of HFNC in the critically ill patients is controversial regarding its effectiveness in preventing Endotracheal Intubation and Invasive Mechanical Ventilation, in terms of treating any type of respiratory failure. It is important for the patients’ outcome to detect early the need for treatment escalation. ROX index [(SpO2/FiO2)/RR] is a handy bedside tool for everyday clinical practice, but further research is needed to determine its reliability and predictive ability for patients’ response to HFNC treatment. Objective Study of the effectiveness of HFNC application in critically ill patients with ARF admitted in the Intensive Care Unit of a Regional University General Hospital. Methods Design: Retrospective, observational, single centre study. Study population: Consecutive critically ill patients with ARF admitted in the Intensive Care Unit from 01/01/2016 to 31/12/2020 and treated with HFNC. Measurements: Data were retrieved from the electronic medical files of ICU PaGNH (CSPlus) including parameters: pH, PaO2, PaO2/FiO2, PaCO2, SpO2, RR and ROX index, before and 1-6-12-24 hours after initiation of HFNC use. Results A total of 204 critically ill patients with ARF with HFNOT were recorded. 22 were diagnosed with SARS CoV-2 infection. Patients were divided into two groups depending on the outcome of HFNC treatment: the success group (N=126) and failure group (N=78), in which treatment escalation was necessary. For the parameters studied, no statistically significant differences were found between the groups for the laboratory values. An alteration was observed in respiratory rate (ΓRR=2, p-value<0.05) for 6 and 24h with HFNC. The PaO2/FiO2 ratio was found to be progressively increasing during the first 12 hours of treatment for the success group, while decreasing during the first 6 hours of treatment for the failure group. Furthermore, it seems that the time period that determines the patient’s response to treatment is between 6-12 hours, where there was a progressive increase of the ROX index for the success group (ROX >7,175), in contrast to its stable or decreasing value for the failure group (ROXmax 5,72±1,73). Conclusion HFNC is considered effective in management of ARF in the critically ill. It is important to monitor the PaO2/FiO2 ratio and the ROX index during the first 12 hours of treatment to determine the patient’s response to treatment.

Language

Greek

Subject

Critically ill

Rox index

Βαρέως πάσχοντες

Δείκτες ROX

Issue date

2021-03-29

Collection

School/Department--School of Medicine--Department of Medicine--Post-graduate theses

Type of Work--Post-graduate theses