Japanese Society for Infection Prevention and Control-Online Journal

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Article in Japanese

Clinical Experience Using High-flow Nasal Cannula for Moderate COVID-19 Pneumonia

Yuta SAKANO¹⁾, Michio HAYASHI²⁾, Hiroko ONO²⁾, Tomoki KOUFUKU²⁾, Isako NAKAI²⁾, Mizuki KUSUHARA²⁾, Tatsuya KADOTANI²⁾, Etsuko SAKAMOTO²⁾, Hiroko FUJIWARA²⁾ and Michio SHIGEMATSU¹⁾
¹⁾Department of Respirology, Sumitomo Hospital, ²⁾Division of Infection Control and Prevention, Sumitomo Hospital

In Japan, critical care beds for ventilatory management were limited during the coronavirus disease 2019 (COVID-19) pandemic. Our hospital treated moderate COVID-19 pneumonia and began using high-flow nasal cannula (HFNC) for patients with the aim of reducing transfers to critical care hospitals. We conducted a retrospective study to determine the outcomes, influencing factors, and effects of avoiding intubation using HFNC. HFNC was implemented when SpO₂ was <93% using a simple mask (O₂, 5 L/min). We performed intubation when oxygenation was not maintained at 60%-70% FiO₂. HFNC was used in negative-pressure rooms or patient rooms at a distance from the green zone. In addition to contact and droplet precautions, staff members undertook precautions against the airborne spread of COVID-19. Thirty-four patients used HFNC and scheduled for intubation when respiratory failure progressed. In these patients, 20 (58.8%) were relieved by HFNC alone and 14 (41.2%) were intubated. Compared to the intubation criteria in the early phase of the pandemic, we could reduce ventilator use by a total of 151 person-days. In hospitals that treat moderate COVID-19, using HFNC for severe COVID-19 pneumonia with certain infection control can be safe, help patients avoid intubation, and improve the conditions in overwhelmed hospitals.

Key words：COVID-19, HFNC, indoor ventilation, infection control, overwhelmed hospital

e-mail: rottertarmin＠gmail.com

Received: June 27, 2022
Accepted: October 20, 2022

38 (2)：68─74,2023