CPAP vs HFNC in treatment of patients with COVID-19 ARDS: A retrospective propensity-matched study
# Background Previous studies exploring the application of noninvasive ventilation or high-flow nasal cannula in patients with COVID-19-related acute respiratory distress syndrome (ARDS) have yielded conflicting results on whether any method of respiratory support is superior. Our aim is to compare...
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| Format: | Article |
| Language: | English |
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Canadian Society of Respiratory Therapists
2024-10-01
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| Series: | Canadian Journal of Respiratory Therapy |
| Online Access: | https://doi.org/10.29390/001c.125145 |
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| author | Ivan Šitum Lovro Hrvoić Ante Erceg Anja Mandarić Dora Karmelić Gloria Mamić Nikolina Džaja Anđela Babić Slobodan Mihaljević Mirabel Mažar Daniel Lovrić |
| author_facet | Ivan Šitum Lovro Hrvoić Ante Erceg Anja Mandarić Dora Karmelić Gloria Mamić Nikolina Džaja Anđela Babić Slobodan Mihaljević Mirabel Mažar Daniel Lovrić |
| author_sort | Ivan Šitum |
| collection | DOAJ |
| description | # Background
Previous studies exploring the application of noninvasive ventilation or high-flow nasal cannula in patients with COVID-19-related acute respiratory distress syndrome (ARDS) have yielded conflicting results on whether any method of respiratory support is superior. Our aim is to compare the efficacy and safety of respiratory therapy with high-flow nasal cannula and noninvasive ventilation with continuous positive airway pressure in treatment of COVID-19-related ARDS.
# Methods
This is a retrospective cohort study based on data from patients who received respiratory support as part of their treatment in the COVID intensive care unit at the University Hospital Centre Zagreb between February 2021 and February 2023. Using propensity score analysis, 42 patients treated with high-flow nasal cannula (HFNC group) were compared to 42 patients treated with noninvasive ventilation with continuous positive airway pressure (CPAP group). Primary outcome was intubation rate.
# Results
Intubation rate was 71.4% (30/42) in the HFNC group and 40.5% (17/42) in the CPAP group (*p* = 0.004). Hazard ratio for intubation was 3.676 (95% confidence interval \[CI\] 1.480 to 9.232) with the HFNC versus CPAP group. Marginally significant difference in survival between the two groups was observed at 30 days (*p* = 0.050) but was statistically significant at 60 days (*p* = 0.043).
# Conclusions
Respiratory support with high-flow nasal cannula and noninvasive ventilation with continuous positive airway pressure yielded significantly different intubation rates in favour of continuous positive airway pressure. The same patients also had better 30-day and 60-day survival post-admission. |
| format | Article |
| id | doaj-art-f494e38204e34d028ab881c7aa4d6e59 |
| institution | Kabale University |
| issn | 2368-6820 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Canadian Society of Respiratory Therapists |
| record_format | Article |
| series | Canadian Journal of Respiratory Therapy |
| spelling | doaj-art-f494e38204e34d028ab881c7aa4d6e592025-02-11T20:30:50ZengCanadian Society of Respiratory TherapistsCanadian Journal of Respiratory Therapy2368-68202024-10-0160CPAP vs HFNC in treatment of patients with COVID-19 ARDS: A retrospective propensity-matched studyIvan ŠitumLovro HrvoićAnte ErcegAnja MandarićDora KarmelićGloria MamićNikolina DžajaAnđela BabićSlobodan MihaljevićMirabel MažarDaniel Lovrić# Background Previous studies exploring the application of noninvasive ventilation or high-flow nasal cannula in patients with COVID-19-related acute respiratory distress syndrome (ARDS) have yielded conflicting results on whether any method of respiratory support is superior. Our aim is to compare the efficacy and safety of respiratory therapy with high-flow nasal cannula and noninvasive ventilation with continuous positive airway pressure in treatment of COVID-19-related ARDS. # Methods This is a retrospective cohort study based on data from patients who received respiratory support as part of their treatment in the COVID intensive care unit at the University Hospital Centre Zagreb between February 2021 and February 2023. Using propensity score analysis, 42 patients treated with high-flow nasal cannula (HFNC group) were compared to 42 patients treated with noninvasive ventilation with continuous positive airway pressure (CPAP group). Primary outcome was intubation rate. # Results Intubation rate was 71.4% (30/42) in the HFNC group and 40.5% (17/42) in the CPAP group (*p* = 0.004). Hazard ratio for intubation was 3.676 (95% confidence interval \[CI\] 1.480 to 9.232) with the HFNC versus CPAP group. Marginally significant difference in survival between the two groups was observed at 30 days (*p* = 0.050) but was statistically significant at 60 days (*p* = 0.043). # Conclusions Respiratory support with high-flow nasal cannula and noninvasive ventilation with continuous positive airway pressure yielded significantly different intubation rates in favour of continuous positive airway pressure. The same patients also had better 30-day and 60-day survival post-admission.https://doi.org/10.29390/001c.125145 |
| spellingShingle | Ivan Šitum Lovro Hrvoić Ante Erceg Anja Mandarić Dora Karmelić Gloria Mamić Nikolina Džaja Anđela Babić Slobodan Mihaljević Mirabel Mažar Daniel Lovrić CPAP vs HFNC in treatment of patients with COVID-19 ARDS: A retrospective propensity-matched study Canadian Journal of Respiratory Therapy |
| title | CPAP vs HFNC in treatment of patients with COVID-19 ARDS: A retrospective propensity-matched study |
| title_full | CPAP vs HFNC in treatment of patients with COVID-19 ARDS: A retrospective propensity-matched study |
| title_fullStr | CPAP vs HFNC in treatment of patients with COVID-19 ARDS: A retrospective propensity-matched study |
| title_full_unstemmed | CPAP vs HFNC in treatment of patients with COVID-19 ARDS: A retrospective propensity-matched study |
| title_short | CPAP vs HFNC in treatment of patients with COVID-19 ARDS: A retrospective propensity-matched study |
| title_sort | cpap vs hfnc in treatment of patients with covid 19 ards a retrospective propensity matched study |
| url | https://doi.org/10.29390/001c.125145 |
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