RT Journal Article
SR Electronic
T1 Late-breaking abstract: High flow oxygen therapy decreases endotracheal intubation requirement in patients with ALI or ARDS
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p1985
VO 38
IS Suppl 55
A1 Guillaume Schnell
A1 Claire Andrejak
A1 Bouchra Lamia
A1 Bénédicte Toublanc
A1 Jean-François Muir
A1 Antoine Cuvelier
A1 Vincent Jounieaux
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p1985.abstract
AB High flow oxygen (HFO) therapy is able to deliver up to 60L/min of a heated and humidified air-oxygen mixture through nasal cannulae and to provide small amount of positive end-expiratory pressure. Our objective was to assess the outcome of patients admitted for acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) who were treated by HFO and to determine if HFO could decrease endotracheal intubation rate.We retrospectively selected 38 consecutive patients (median age 57 yrs) admitted in ICU for ALI (n=5, 13%) or ARDS (n=33, 87%) and who underwent HFO (Optiflow®, Fisher & Paykel, France) at admission (PaO2 = 65 mmHg, PaO2/FiO2 = 110±71 mmHg). Most of our population (26/38 patients, 68%) resolved their acute episode with HFO. In this group, invasive ventilation was not required and this decision was not stated on EOL care (success group). PaO2/FiO2 at admission was found higher in the success group (126 vs. 76 mmHg, p=0.04). Failure patients (12/38, 32%) exhibited more comorbidities (Charlson's score = 4.5 vs. 2.5, p=0.034) and appeared more severe at admission (SAPS2 = 45 vs. 31, p=0.0054). After 24 hours, the %FiO2 under HFO was significantly lower in the success group (50% vs. 70%, p=0.004). The hospitalization length was similar in both groups (p=0.28). Hospital mortality rate was significantly higher in the failure group than in the success group ((92% vs. 4%, p<0.0001) as was the 28-days mortality rate (respectively: 83% and 4%, p<0.0001).In conclusion, HFO may avoid endotracheal intubation during ALI/ARDS and its usefulness in hypoxemic respiratory failure needs further investigations.