The Role of High Flow Nasal Oxygen in the Management of Severe COVID-19: A Systematic Review

Authors

  • Themistoklis Paraskevas Department of Internal Medicine. University Hospital of Patras. Patras. https://orcid.org/0000-0002-5095-4916
  • Eleousa Oikonomou Department of Internal Medicine. University Hospital of Patras. Patras. https://orcid.org/0000-0002-8618-9988
  • Maria Lagadinou Department of Internal Medicine. University Hospital of Patras. Patras.
  • Vasileios Karamouzos Intensive Care Unit. University Hospital of Patras. Patras. https://orcid.org/0000-0003-1122-4213
  • Nikolaos Zareifopoulos Department of Internal Medicine. University Hospital of Patras. Patras.
  • Despoina Spyropoulou Department of Radiation Oncology. University Hospital of Patras. Patras.
  • Dimitrios Velissaris Department of Internal Medicine. University Hospital of Patras. Patras. https://orcid.org/0000-0003-4048-740X

DOI:

https://doi.org/10.20344/amp.16686

Keywords:

Cannula, COVID-19, Critical Care, Noninvasive Ventilation, Oxygen/therapeutic use, Respiration, Artificial, Respiratory Distress, Syndrome

Abstract

Introduction: Oxygen therapy remains the cornerstone for managing patients with severe SARS-CoV-2 infection and several modalities of non-invasive ventilation are used worldwide. High-flow oxygen via nasal canula is one therapeutic option which may in certain cases prevent the need of mechanical ventilation. The aim of this review is to summarize the current evidence on the use of high-flow nasal oxygen in patients with severe SARS-CoV-2 infection.
Material and Methods: We conducted a systematic literature search of the databases PubMed and Cochrane Library until April 2021 using the following search terms: “high flow oxygen and COVID-19” and “high flow nasal and COVID-19’’.
Results: Twenty-three articles were included in this review, in four of which prone positioning was used as an adjunctive measure. Most of the articles were cohort studies or case series. High-flow nasal oxygen therapy was associated with a reduced need for invasive ventilation compared to conventional oxygen therapy and led to an improvement in secondary clinical outcomes such as length of stay. The efficacy of high-flow nasal oxygen therapy was comparable to that of other non-invasive ventilation options, but its tolerability is likely higher. Failure of this modality was associated with increased mortality.
Conclusion: High flow nasal oxygen is an established option for respiratory support in COVID-19 patients. Further investigation is required to quantify its efficacy and utility in preventing the requirement of invasive ventilation.

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Author Biography

Dimitrios Velissaris, Department of Internal Medicine. University Hospital of Patras. Patras.

Dimitrios Velissaris MD, PhD

Associate Professor of Internal and Emergency Medicine

Department of Internal Medicine, University Hospital of Patras

 

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Published

2022-06-01

How to Cite

1.
Paraskevas T, Oikonomou E, Lagadinou M, Karamouzos V, Zareifopoulos N, Spyropoulou D, Velissaris D. The Role of High Flow Nasal Oxygen in the Management of Severe COVID-19: A Systematic Review. Acta Med Port [Internet]. 2022 Jun. 1 [cited 2023 Feb. 6];35(6):476-83. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/16686

Issue

Section

Review Articles