Late Breaking Abstract - A SINGLE-CENTER EXPERIENCE WITH HIGH-FLOW NASAL CANNULA FOR COVID-19 PATIENTS WITH ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS)

Introduction: A respiratory illness caused by a novel coronavirus, the SARS-CoV-2 coronavirus, began in China in December 2019 and subsequently spread around the world. The efficacy of high-flow nasal cannula oxygen therapy (HFNC) is still unknown in patients with this disease. The principal aim of this research is to describe its utility as a therapy for the treatment of the Acute Respiratory Distress Syndrome (ARDS) caused by SARS-CoV-2 Methods: Retrospective analysis carried out from March 18 to April 18, 2020. 196 patients with bilateral pneumonia were admitted to our pulmonology unit during this period. 40 of them suffered from ARDS and were treated with HFNC in which whom intubation rate and mortality were analyzed. Results: Mean age was 58.9 years, and 70% were men. Twenty-one patients (52.5%) experienced therapy failure and required intubation, with a median time-to-intubation of 2 days (IQR: 1-4). After initiating HFNC, the SpO2/FiO2 ratio was significantly better in the group that did not require intubation (113.4±6.6 vs 93.7±6.7, p=0.020), as was the ROX index (5±1.6 vs 4±1, p=0.018). A ROX index less than 4.94 measured 2 to 6 hours after the start of therapy was associated with increased risk of intubation (HR 4.03 [95% CI 1.18 – 13.7]; p=0.026). The overall mortality rate was nine patients (22.5%), all of whom were in the failed HFNC therapy group. Conclusions: High-flow therapy is a useful treatment in ARDS in order to avoid intubation or as a bridge therapy, and no increased mortality was observed secondary to the delay in intubation. After initiating HFNC, a ROX index below 4.94 predicts the need for intubation