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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


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

38 (2):68─74,2023

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