High-flow Nasal Cannula therapy: A feasible treatment for vulnerable elderly COVID-19 patients in the wards.
Job van Steenkiste, Michael C van Herwerden, Dolf Weller and 7 others
PMID 34098235WHAT IT FOUND
High-flow nasal cannula therapy failed to save most frail, elderly COVID-19 patients on hospital wards who were not eligible for intensive care.
Only 25% survived to discharge, with failure driven by persistent low oxygen levels.
Key findings
01The overall survival rate at hospital discharge for this frail cohort receiving high-flow nasal cannula therapy was 25%.
02The primary reason for treatment failure was hypoxemic respiratory failure, occurring in 69% of patients.
03Survivors were significantly younger (median 69.5 years) than non-survivors (median 80.5 years).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was small, with only 32 patients, which limits the ability to identify reliable predictors of survival. There was no comparison group receiving standard oxygen therapy or other non-invasive ventilation, so it is impossible to determine if HFNC provided any benefit over conventional care. The cohort consisted of patients already deemed ineligible for intensive care, meaning the results apply only to this specific frail population and not to all patients with respiratory failure.
Declared interests
The authors declare that they have no competing interests.
The easy way to misread this
Do not interpret the low survival rate as evidence that high-flow nasal cannula therapy is ineffective for all patients with respiratory failure. This study only looked at frail, elderly patients who were explicitly excluded from intensive care, so the poor outcomes reflect the severity of their underlying condition and lack of escalation options, not necessarily the failure of the device itself.