1. Início
  2. Publicações
  3. High-flow nasal oxygen versus conventional oxygen therapy in patients with COVID-19 pneumonia and mild hypoxaemia: a randomised controlled trial

High-flow nasal oxygen versus conventional oxygen therapy in patients with COVID-19 pneumonia and mild hypoxaemia: a randomised controlled trial

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • João Carlos Winck Fernandes Cruz

    Autor

Participantes de fora da FMUP

  • Crimi, C
  • Noto, A
  • Madotto, F
  • Ippolito, M
  • Nolasco, S
  • Campisi, R
  • De Vuono, S
  • Fiorentino, G
  • Pantazopoulos, I
  • Chalkias, A
  • Libra, A
  • Mattei, A
  • Scala, R
  • Clini, EM
  • Ergan, B
  • Lujan, M
  • Giarratano, A
  • Carlucci, A
  • Gregoretti, C
  • Groff, P
  • Cortegiani, A
  • COVID-HIGH Investigators

Abstract

Rationale In patients with COVID-19 pneumonia and mild hypoxaemia, the clinical benefit of high-flow nasal oxygen (HFNO) remains unclear. We aimed to examine whether HFNO compared with conventional oxygen therapy (COT) could prevent escalation of respiratory support in this patient population. Methods In this multicentre, randomised, parallel-group, open-label trial, patients with COVID-19 pneumonia and peripheral oxygen saturation (SpO(2)) <= 92% who required oxygen therapy were randomised to HFNO or COT. The primary outcome was the rate of escalation of respiratory support (ie, continuous positive airway pressure, non-invasive ventilation or invasive mechanical ventilation) within 28 days. Among secondary outcomes, clinical recovery was defined as the improvement in oxygenation (SpO(2)) >= 96% with fractional inspired oxygen (FiO(2)) <= 30% or partial pressure of arterial carbon dioxide/FiO(2 )ratio >300 mm Hg). Results Among 364 randomised patients, 55 (30.3%) of 181 patients assigned to HFNO and 70 (38.6%) of 181 patients assigned to COT underwent escalation of respiratory support, with no significant difference between groups (absolute risk difference -8.2% (95% CI -18% to +1.4%); RR 0.79 (95% CI 0.59 to 1.05); p=0.09). There was no significant difference in clinical recovery (69.1% vs 60.8%; absolute risk difference 8.2% (95% CI -1.5% to +18.0%), RR 1.14 (95% CI 0.98 to 1.32)), intensive care unit admission (7.7% vs 11.0%, absolute risk difference -3.3% (95% CI -9.3% to +2.6%)), and in hospital length of stay (11 (IQR 8-17) vs 11 (IQR 7-20) days, absolute risk difference -1.0% (95% CI -3.1% to +1.1%)). Conclusions Among patients with COVID-19 pneumonia and mild hypoxaemia, the use of HFNO did not significantly reduce the likelihood of escalation of respiratory support.

Dados da publicação

ISSN/ISSNe:
1468-3296, 0040-6376

Thorax  BMJ Publishing Group

Tipo:
Article
Páginas:
354-361
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 39

Citações Recebidas na Scopus: 53

Documentos

  • Não há documentos

Métricas

Filiações mostrar / ocultar

Keywords

  • COVID-19; Humans; Hypoxia; Oxygen; Oxygen Inhalation Therapy; Respiration, Artificial; oxygen; oxygen; adult; Article; artificial ventilation; assisted ventilation; breathing rate; cardiomyopathy; continuous positive airway pressure; controlled study; coronavirus disease 2019; female; high flow nasal cannula therapy; hospital admission; hospital mortality; human; hypercapnia; hypoxemia; immunofluorescence; intensive care unit; invasive ventilation; lung embolism; major clinical study; male; middle aged; mortality; multicenter study; noninvasive ventilation; open study; outcome assessment; oxygen desaturation; oxygen saturation; oxygen therapy; oxygenation; partial pressure; pneumonia; positive end expiratory pressure ventilation; randomized controlled trial; risk assessment; clinical trial; complication; hypoxia

Campos de estudo

Proyectos asociados

Esclerose Lateral Amiotrófica um novo paradigma

Investigador Principal: João Carlos Winck Fernandes Cruz

Estudo Clínico Académico . 2020

Citar a publicação

Partilhar a publicação