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Case Reports
. 2022 May 24:2022:5004108.
doi: 10.1155/2022/5004108. eCollection 2022.

Supplementation of High Velocity Nasal Insufflation with a Nonrebreather Mask for Severe Hypoxemic Respiratory Failure in Adult Patients with COVID-19

Jessica S Whittle  1   2 , Jigme Sethi  3 , Leonithas I Volakis  4 , Jeremy Greenberg  3
Affiliations
Case Reports

Supplementation of High Velocity Nasal Insufflation with a Nonrebreather Mask for Severe Hypoxemic Respiratory Failure in Adult Patients with COVID-19

Jessica S Whittle et al. Case Rep Crit Care. .

Abstract

The unique clinical features of COVID-19-related acute hypoxemic respiratory failure, as well as the widespread impact leading to resource strain, have led to reconsiderations of classic approaches to respiratory support. HFNO includes high flow nasal cannula (HFNC) and high velocity nasal insufflation (HVNI). There are currently no widely accepted criteria for HFNO failure. We report a series of three patients who experienced COVID-19-related acute severe hypoxemic respiratory failure. Each patient was initially managed with HVNI and had a ROX index < 3.85, suggesting HFNO failure was likely. They were subsequently managed with a nonrebreather mask (NRM) overlying and in combination with HVNI at maximal settings and were able to be managed without the need for invasive mechanical ventilation.

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Conflict of interest statement

JW became employed by Vapotherm, Inc. as VP of Clinical Research, after this manuscript was submitted. JG has served as a consultant to Vapotherm, Inc. within the last 3 years for the development of educational materials. LV is a Research Scientist with Vapotherm, Inc. JS has no disclosure.

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