Dual Oxygenation in Covid-19 - a Retrospective Cohorot Study

Gur, Ivan; Fuchs, E

doi:10.1183/13993003.congress-2022.2225

Cited by 1 publication

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The decrease in room air entrainment might be even more significant when a highly compliant reservoir is added [ 9 ]. The large diameter and proximity of the reservoir bag minimize the resistance of this source of effectively pure oxygen during inspiration [ 7 ]. Since, as discussed above, the limiting factor in respiratory failure seems to be flow rather than volume, even the modest volume (but high flow) reservoir bag could help address the increased PIF needs of patients with respiratory failure.…”

Section: Discussionmentioning

confidence: 99%

“…HFNC has been extensively shown to improve oxygenation by reducing effective dead space ventilation and markedly increasing the fraction of inspired oxygen (FiO 2 ) [ 5 ], as well as significantly increasing the end expiratory pressure [ 6 ]. This modality was also shown to reduce 30-day mortality compared to other noninvasive measures [ 7 ]. Some alterations to the flow rate and oxygen concentrations of HFNC [ 8 ], the effect of manipulating the delivery device [ 9 ], opening to shutting the patient’s mouth [ 6 ] or the addition of a surgical mask on top of the HFNC have been empirically evaluated [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Combining reservoir mask oxygenation with high-flow nasal cannula in the treatment of hypoxemic respiratory failure among patients with COVID-19 pneumonia: a retrospective cohort study

Gur,

Zalts,

Dotan

et al. 2023

ACC

View full text Add to dashboard Cite

Background: Concerns regarding positive-pressure-ventilation for the treatment of coronavirus disease 2019 (COVID-19) hypoxemia led the search for alternative oxygenation techniques. This study aimed to assess one such method, dual oxygenation, i.e., the addition of a reservoir mask (RM) on top of a high-flow nasal cannula (HFNC).Methods: In this retrospective cohort study, the records of all patients hospitalized with COVID-19 during 2020–2022 were reviewed. Patients over the age of 18 years with hypoxemia necessitating HFNC were included. Exclusion criteria were positive-pressure-ventilation for any indication other than hypoxemic respiratory failure, transfer to another facility while still on HFNC and “do-not-intubate/resuscitate” orders. The primary outcome was mortality within 30 days from the first application of HFNC. Secondary outcomes were intubation and admission to the intensive care unit.Results: Of 659 patients included in the final analysis, 316 were treated with dual oxygenation and 343 with HFNC alone. Propensity for treatment was estimated based on background diagnoses, laboratories and vital signs upon admission, gender and glucocorticoid dose. Inverse probability of treatment weighted regression including age, body mass index, Sequential Organ Failure Assessment (SOFA) score and respiratory rate oxygenation index showed treatment with dual oxygenation to be associated with lower 30-day mortality (adjusted hazard ratio, 0.615; 95% confidence interval, 0.469–0.809). Differences in the secondary outcomes did not reach statistical significance.Conclusions: Our study suggests that the addition of RM on top of HFNC may be associated with decreased mortality in patients with severe COVID-19 hypoxemia.

show abstract

Section: Discussionmentioning

confidence: 99%