Description of the experience with the use of high-flow nasal cannulas in adult patients with COVID-19, Hospital Universitario San Ignacio – Bogotá, D.C. 2020 to 2022
Descripción de la experiencia con el uso de cánulas nasales de alto flujo en pacientes adultos con COVID-19. Hospital Universitario San Ignacio, Bogotá D.C. 2020-2022
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Escamilla Osorio MG, Moreno Carrillo A, Cubillos Rojas JD, Tellez Ariza LD, Rodríguez Prada C, Acevedo Guiot A del P, et al. Description of the experience with the use of high-flow nasal cannulas in adult patients with COVID-19, Hospital Universitario San Ignacio – Bogotá, D.C. 2020 to 2022.
rev. colomb. neumol. [Internet]. 2025 Jul. 30 [cited 2025 Oct. 13];37(2):41-59. Disponible en: https://doi.org/10.30789/rcneumologia.v37.n2.2025.987
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Introduction: The COVID-19 pandemic prompted the use of non-invasive therapies such as high-flow nasal cannula (HFNC) to manage hypoxemia, aiming to reduce the need for invasive mechanical ventilation. Objective: To describe the experience at Hospital Universitario San Ignacio with the use of HFNC in adult patients with COVID-19 and its impact on the need for orotracheal intubation and mortality.
Methods: Retrospective observational study including 604 patients with confirmed COVID-19 diagnosis by RT-PCR or antigen testing. Clinical, paraclinical, and outcome variables, such as the need for intubation and mortality, were analyzed.
Results: The cohort mainly consisted of male patients (62.1%) with a median age of 62 years. The most common comorbidities were hypertension (36.9%), diabetes (18.7%), and obesity (17.9%). Most patients started HFNC 53 hours after diagnosis. The ROX index decreased from 16.4 to 4.6 before intubation. Overall, 58.8% of patients required intubation; the global mortality rate was 24.2%, higher among intubated patients (31.5%) and those admitted to the ICU (26.4%). Among non-intubated patients, 86.3% survived, and 73.1% did not require admission to the intensive care unit (ICU).
Conclusions: The use of HFNC may be associated with a reduced need for intubation and a higher survival rate in patients with COVID-19, particularly when implemented early in the disease course. These findings support the role of HFNC as an effective tool in managing acute respiratory failure secondary to COVID-19.
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- Giwa AL, Desai A, Duca A. Novel 2019 coronavirus SARS-CoV-2 (COVID-19): An updated overview for emergency clinicians. Emerg Med Pract. 2020;22(5):1-28. PMID: 32207910
- Cook TM, El‐Boghdadly K, McGuire B, McNarry AF, Patel A, Higgs A. Consensus guidelines for managing the airway in patients with COVID ‐19: Guidelines from the Difficult Airway Society, the Association of Anaesthetists the Intensive Care Society, the Faculty of Intensive Care Medicine and the Royal College of Anaesthetists. Anaesthesia junio de 2020;75(6):785–99. doi: https://doi.org/10.1111/anae.15054
- Berlin DA, Gulick RM, Martinez FJ. Severe Covid-19. N Engl J Med. 2020;383(25):2451-60. doi: https://doi.org/10.1056/nejmcp2009575. DOI: https://doi.org/10.1056/NEJMcp2009575
- Lodeserto FJ, Lettich TM, Rezaie SR. High-flow Nasal Cannula: Mechanisms of Action and Adult and Pediatric Indications. Cureus. 2018;10(11). doi: https://doi.org/10.7759/cureus.3639. DOI: https://doi.org/10.7759/cureus.3639
- Gershengorn HB, Hu Y, Chen JT, Hsieh SJ, Dong J, Gong MN, et al. The impact of high-flow nasal cannula use on patient mortality and the availability of mechanical ventilators in COVID-19. Ann Am Thorac Soc. 2021;18(4):623-31. doi: https://doi.org/10.1513/annalsats.202007-803oc. DOI: https://doi.org/10.1513/AnnalsATS.202007-803OC
- Nishimura M. High-flow nasal cannula oxygen therapy devices. Respir Care. 2019;64(6):735-42. doi: https://doi.org/10.4187/respcare.06718. DOI: https://doi.org/10.4187/respcare.06718
- Nishimura M. High-flow nasal cannula oxygen therapy in adults. J Intensive Care. 2015;3(1):1-8. doi: https://doi.org/10.1186/s40560-015-0084-5. DOI: https://doi.org/10.1186/s40560-015-0084-5
- Mauri T, Wang YM, Corte FD, Corcione N, Spinelli E, Pesenti A. Nasal high flow: Physiology, efficacy and safety in the acute care setting, a narrative review. Open Access Emerg Med. 2019;11:109-20. doi: https://doi.org/10.2147/OAEM.S180197. DOI: https://doi.org/10.2147/OAEM.S180197
- Cook TM, El-Boghdadly K, McGuire B, McNarry AF, Patel A, Higgs A. Consensus guidelines for managing the airway in patients with COVID-19: Guidelines from the Difficult Airway Society, the Association of Anaesthetists the Intensive Care Society, the Faculty of Intensive Care Medicine and the Royal College of Anaesthetist. Anaesthesia. 2020;75(6):785-99. doi: https://doi.org/10.1111/anae.15054. DOI: https://doi.org/10.1111/anae.15054
- Agarwal A, Basmaji J, Muttalib F, Granton D, Chaudhuri D, Chetan D, et al. High-flow nasal cannula for acute hypoxemic respiratory failure in patients with COVID-19: systematic reviews of effectiveness and its risks of aerosolization, dispersion, and infection transmission. Can J Anesth . 2020;67(9):1217-48. doi: https://doi.org/10.1007/s12630-020-01740-2 DOI: https://doi.org/10.1007/s12630-020-01740-2
- Whittle JS, Pavlov I, Sacchetti AD, Atwood C, Rosenberg MS. Respiratory support for adult patients with COVID‐19. J Am Coll Emerg Physicians Open. 2020;1(2):95-101. doi: https://doi.org/10.1002/emp2.12071. DOI: https://doi.org/10.1002/emp2.12071
- Vianello A, Arcaro G, Molena B, Turato C, Sukthi A, Guarnieri G, et al. High-flow nasal cannula oxygen therapy to treat patients with hypoxemic acute respiratory failure consequent to SARS-CoV-2 infection. Thorax. 2020;75(11):998-1000. doi: https://doi.org/10.1136/thoraxjnl-2020-214993. DOI: https://doi.org/10.1136/thoraxjnl-2020-214993
- Wang K, Zhao W, Li J, Shu W, Duan J. The experience of high-flow nasal cannula in hospitalized patients with 2019 novel coronavirus-infected pneumonia in two hospitals of Chongqing, China. Ann Intensive Care. 2020;10(1):0-4. doi: https://doi.org/10.1186/s13613-020-00653-z. DOI: https://doi.org/10.1186/s13613-020-00653-z
- Frat J-P, Thille AW, Mercat A, Girault C, Ragot S, Perbet S, et al. High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure. N Engl J Med. 2015;372(23):2185-96. doi: https://doi.org/10.1056/NEJMoa1503326. DOI: https://doi.org/10.1056/NEJMoa1503326
- Teng XB, Shen Y, Han MF, Yang G, Zha L, Shi JF. The value of high-flow nasal cannula oxygen therapy in treating novel coronavirus pneumonia. Eur J Clin Invest. 2021;51(3):1-6. doi: https://doi.org/10.1111/eci.13435. DOI: https://doi.org/10.1111/eci.13435
- Blez D, Soulier A, Bonnet F, Gayat E, Garnier M. Monitoring of high-flow nasal cannula for SARS-CoV-2 severe pneumonia: less is more, better look at respiratory rate. Intensive Care Med. 2020;46(11):2094-5. doi: https://doi.org/10.1007/s00134-020-06199-9 DOI: https://doi.org/10.1007/s00134-020-06199-9
- Hu M, Zhou Q, Zheng R, Li X, Ling J, Chen Y, et al. Application of high-flow nasal cannula in hypoxemic patients with COVID-19: a retrospective cohort study. BMC Pulm Med. 2020;20(1):1-7. doi: https://doi.org/10.1186/s12890-020-01354-w DOI: https://doi.org/10.1186/s12890-020-01354-w
- Singh A, Khanna P, Sarkar S. High-Flow Nasal Cannula, a Boon or a Bane for COVID-19 Patients? An Evidence-Based Review. Curr Anesthesiol Rep. 2021;11, 101-106. doi: https://doi.org/10.1007/s40140-021-00439-4 DOI: https://doi.org/10.1007/s40140-021-00439-4
- Pérez-Nieto OR, Guerrero-Gutiérrez MA, Deloya-Tomas E, Ñamendys-Silva SA. Prone positioning combined with high-flow nasal cannula in severe noninfectious ARDS. Crit Care. 2020;24(1):10-2. https://doi.org/10.1186/s13054-020-2821-y DOI: https://doi.org/10.1186/s13054-020-2821-y
- Lu X, Xu S. Therapeutic effect of high-flow nasal cannula on severe COVID-19 patients in a makeshift intensive-care unit: A case report. Medicine (Baltimore). 2020;99(21):e20393. doi: https://doi.org/10.1097/MD.0000000000020393 DOI: https://doi.org/10.1097/MD.0000000000020393
- Calligaro GL, Lalla U, Audley G, Gina P, Miller MG, Mendelson M, et al. The utility of high-flow nasal oxygen for severe COVID-19 pneumonia in a resource-constrained setting: A multi-centre prospective observational study: HFNO for COVID-19 pneumonia. EClinicalMedicine. 2020;000:1-9. doi: https://doi.org/10.1016/j.eclinm.2020.100570. DOI: https://doi.org/10.1016/j.eclinm.2020.100570
- Patel M, Gangemi A, Marron R, Chowdhury J, Yousef I, Zheng M, et al. Retrospective analysis of high flow nasal therapy in COVID-19-related moderate-to-severe hypoxaemic respiratory failure. BMJ Open Respir Res. 2020;7(1):1-11. doi: https://doi.org/10.1136/bmjresp-2020-000650. DOI: https://doi.org/10.1136/bmjresp-2020-000650
- Kharroubi SA, Diab-El-Harake M. Sex-differences in COVID-19 diagnosis, risk factors and disease comorbidities: A large US-based cohort study. Front Public Heal. 2022;10(March 2020). doi: https://doi.org/10.3389/fpubh.2022.1029190. DOI: https://doi.org/10.3389/fpubh.2022.1029190
- Yau CE, Lee DYX, Vasudevan A, Goh KJ, Wong E, Ho AFW, et al. Performance of the ROX index in predicting high flow nasal cannula failure in COVID-19 patients: a systematic review and meta-analysis. Crit Care. 2023;27(1):1-13. doi: https://doi.org/10.1186/s13054-023-04567-7
- Mucha SR, Dugar S, McCrae K, Joseph DE, Bartholomew J, Sacha G, et al. Coagulopathy in COVID-19: Posted april 24, 2020. Cleve Clin J Med. 2020;87(5):461-8. doi: https://doi.org/10.3949/ccjm. 87a.ccc024 DOI: https://doi.org/10.3949/ccjm.87a.ccc024
- Giwa AL, Desai A, Duca A. Novel 2019 coronavirus SARS-CoV-2 (COVID-19): An updated overview for emergency clinicians. Emerg Med Pract. 2020;22(5):1-28. PMID: 32286766.
- Swenson KE, Hardin CC. Pathophysiology of Hypoxemia in COVID-19 Lung Disease. 2023 Jun;44(2):239-248. doi: https://doi.org/10.1016/j.ccm.2022.11.007. DOI: https://doi.org/10.1016/j.ccm.2022.11.007
- Yau CE, Lee DYX, Vasudevan A, Goh KJ, Wong E, Ho AFW, et al. Performance of the ROX index in predicting high flow nasal cannula failure in COVID-19 patients: a systematic review and meta-analysis. Crit Care. 2023;27(1):1-13. doi: https://doi.org/10.1186/s13054-023-04567-7 DOI: https://doi.org/10.1186/s13054-023-04567-7
- Terzic CM, Medina-Inojosa BJ. Cardiovascular Complications of Coronavirus Disease-2019. Phys Med Rehabil Clin N Am. 2023;34(3):551-61. doi: https://doi.org/10.1016/j.pmr.2023.03.003 DOI: https://doi.org/10.1016/j.pmr.2023.03.003
- Ospina-Tascón GA, Calderón-Tapia LE, García AF, Zarama V, Gómez-Álvarez F, Álvarez-Saa T, Pardo-Otálvaro S, et al. Effect of High-Flow Oxygen Therapy vs Conventional Oxygen Therapy on Invasive Mechanical Ventilation and Clinical Recovery in Patients With Severe COVID-19: A Randomized Clinical Trial. JAMA. 2021 Dec 7;326(21):2161-2171. doi: https://doi.org/10.1001/jama.2021.20714. Erratum in: JAMA. 2022 Mar 15;327(11):1093. doi: https://doi.org/10.1001/jama.2022.1908. DOI: https://doi.org/10.1001/jama.2022.1908
- Frat JP, Marchasson L, Arrivé F, Coudroy R. High-flow nasal cannula oxygen therapy in acute hypoxemic respiratory failure and COVID-19-related respiratory failure. J Intensive Med. 2023;3(1):20-6. DOI: https://doi.org/10.1016/j.jointm.2022.07.005
- Hincapié Díaz GA, Echeverría González CL, Enciso Bahamón LF. Usos de la cánula nasal de alto flujo para pacientes con COVID-19. ¿Cómo funciona, cuáles son sus indicaciones? ¿Es segura en los pacientes con insuficiencia respiratoria aguda hipoxémica? Rev Med. 2021;28(2):25-34. DOI: https://doi.org/10.18359/rmed.5101
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