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. 2023 Mar;53(2):104635.
doi: 10.1016/j.idnow.2022.11.004. Epub 2022 Nov 24.

High-flow cannula for frail patients with SARS-CoV-2 infection non-eligible for intensive care unit management

L Bouetard  1 , T Flamand  2 , D Vignes  3 , A Robert  2 , R Sterpu  3 , L Lemonnier  2 , M Mion  4 , V Gerber  5 , S Abgrall  1 , M Martinot  6
Affiliations

High-flow cannula for frail patients with SARS-CoV-2 infection non-eligible for intensive care unit management

L Bouetard et al. Infect Dis Now. 2023 Mar.

Abstract

Objectives: High-flow nasal cannula (HFNC) was widely used during the COVID-19 pandemic in intensive care units (ICU), but there is no recommendation for elderly patients non-eligible for ICU management. We aimed to describe the outcomes of HFNC treatment in patients with COVID-19 who are not eligible for ICU management.

Methods: Retrospective bicentric cohort study performed between September 1, 2020 and June 30, 2021 in two infectious diseases departments of Colmar Hospital and Antoine Beclere University Hospital, France.

Results: Sixty-four patients were treated with HFNC: 33 in Colmar and 31 in Beclere hospital (median age: 85 years; IQ, 82-92). Of these, 16 patients survived (25%). Surviving patients had a lower Charlson comorbidity index score than deceased patients (five vs six; p = 0.02).

Conclusions: Despite a high death rate, with survivors being younger and having fewer comorbidities, HFNC is an easy tool to implement in non-ICU wards for the frailest patients.

Keywords: COVID-19; Elderly; High-flow nasal cannula; High-flow oxygen; Tocilizumab.

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