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High-flow nasal cannula therapy for acute respiratory failure in patients with interstitial pneumonia: a retrospective observational study.
Nagoya J Med Sci. 2020 May; 82(2):301-313.NJ

Abstract

High-flow nasal cannula (HFNC) oxygen is a therapy that has demonstrated survival benefits in acute respiratory failure (ARF). However, the role of HFNC in ARF due to interstitial pneumonia (IP) is unknown. The aim of this study was to compare the effects of HFNC therapy and non-invasive positive pressure ventilation (NPPV) in ARF due to IP. This retrospective observational study included 32 patients with ARF due to IP who were treated with HFNC (n = 13) or NPPV (n = 19). The clinical characteristics, intubation rate and 30-day mortality were analyzed and compared between the HFNC group and the NPPV group. Predictors of 30-day mortality were evaluated using a logistic regression model. HFNC group showed higher mean arterial blood pressure (median 92 mmHg; HFNC group vs 74 mmHg; NPPV group) and lower APACHEII score (median 22; HFNC group vs 27; NPPV group) than NPPV group. There was no significant difference in the intubation rate at day 30 between the HFNC group and the NPPV group (8% vs 37%: p = 0.069); the mortality rate at 30 days was 23% and 63%, respectively. HFNC therapy was a significant determinant of 30-day mortality in univariate analysis, and was confirmed to be an independent significant determinant of 30-day mortality in multivariate analysis (odds ratio, 0.148; 95% confidence interval, 0.025-0.880; p = 0.036). Our findings suggest that HFNC therapy can be a possible option for respiratory management in ARF due to IP. The results observed here warrant further investigation of HFNC therapy in randomized control trials.

Authors+Show Affiliations

Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan. Pulmonary, Critical Care and Sleep Medicine Section, Department of Internal Medicine, Yale University School of Medicine, New Haven, United States of America.Department of Emergency and Critical Care, Nagoya University Graduate School of Medicine, Nagoya, Japan.Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan.Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.Department of Emergency and Critical Care, Nagoya University Graduate School of Medicine, Nagoya, Japan.Department of Emergency and Critical Care, Nagoya University Graduate School of Medicine, Nagoya, Japan.Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan.Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan. Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.

Pub Type(s)

Comparative Study
Journal Article
Observational Study

Language

eng

PubMed ID

32581409

Citation

Omote, Norihito, et al. "High-flow Nasal Cannula Therapy for Acute Respiratory Failure in Patients With Interstitial Pneumonia: a Retrospective Observational Study." Nagoya Journal of Medical Science, vol. 82, no. 2, 2020, pp. 301-313.
Omote N, Matsuda N, Hashimoto N, et al. High-flow nasal cannula therapy for acute respiratory failure in patients with interstitial pneumonia: a retrospective observational study. Nagoya J Med Sci. 2020;82(2):301-313.
Omote, N., Matsuda, N., Hashimoto, N., Nishida, K., Sakamoto, K., Ando, A., Nakahara, Y., Nishikimi, M., Higashi, M., Matsui, S., & Hasegawa, Y. (2020). High-flow nasal cannula therapy for acute respiratory failure in patients with interstitial pneumonia: a retrospective observational study. Nagoya Journal of Medical Science, 82(2), 301-313. https://doi.org/10.18999/nagjms.82.2.301
Omote N, et al. High-flow Nasal Cannula Therapy for Acute Respiratory Failure in Patients With Interstitial Pneumonia: a Retrospective Observational Study. Nagoya J Med Sci. 2020;82(2):301-313. PubMed PMID: 32581409.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High-flow nasal cannula therapy for acute respiratory failure in patients with interstitial pneumonia: a retrospective observational study. AU - Omote,Norihito, AU - Matsuda,Naoyuki, AU - Hashimoto,Naozumi, AU - Nishida,Kazuki, AU - Sakamoto,Koji, AU - Ando,Akira, AU - Nakahara,Yoshio, AU - Nishikimi,Mitsuaki, AU - Higashi,Michiko, AU - Matsui,Shigeyuki, AU - Hasegawa,Yoshinori, PY - 2020/6/26/entrez PY - 2020/6/26/pubmed PY - 2021/4/29/medline KW - critical care KW - nasal cannula KW - pulmonary fibrosis KW - respiratory failure SP - 301 EP - 313 JF - Nagoya journal of medical science JO - Nagoya J Med Sci VL - 82 IS - 2 N2 - High-flow nasal cannula (HFNC) oxygen is a therapy that has demonstrated survival benefits in acute respiratory failure (ARF). However, the role of HFNC in ARF due to interstitial pneumonia (IP) is unknown. The aim of this study was to compare the effects of HFNC therapy and non-invasive positive pressure ventilation (NPPV) in ARF due to IP. This retrospective observational study included 32 patients with ARF due to IP who were treated with HFNC (n = 13) or NPPV (n = 19). The clinical characteristics, intubation rate and 30-day mortality were analyzed and compared between the HFNC group and the NPPV group. Predictors of 30-day mortality were evaluated using a logistic regression model. HFNC group showed higher mean arterial blood pressure (median 92 mmHg; HFNC group vs 74 mmHg; NPPV group) and lower APACHEII score (median 22; HFNC group vs 27; NPPV group) than NPPV group. There was no significant difference in the intubation rate at day 30 between the HFNC group and the NPPV group (8% vs 37%: p = 0.069); the mortality rate at 30 days was 23% and 63%, respectively. HFNC therapy was a significant determinant of 30-day mortality in univariate analysis, and was confirmed to be an independent significant determinant of 30-day mortality in multivariate analysis (odds ratio, 0.148; 95% confidence interval, 0.025-0.880; p = 0.036). Our findings suggest that HFNC therapy can be a possible option for respiratory management in ARF due to IP. The results observed here warrant further investigation of HFNC therapy in randomized control trials. SN - 2186-3326 UR - https://www.unboundmedicine.com/medline/citation/32581409/High_flow_nasal_cannula_therapy_for_acute_respiratory_failure_in_patients_with_interstitial_pneumonia:_a_retrospective_observational_study_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32581409/ DB - PRIME DP - Unbound Medicine ER -