Oxygen Consumption with High-Flow Nasal Oxygen versus Mechanical Ventilation- An International Multicenter Observational Study in COVID-19 Patients (PROXY-COVID)
Botta, Michela (Amsterdam UMC. University Medical Center)
Caritg, Oriol (Hospital Universitari Vall d'Hebron)
van Meenen, David M.P. (Amsterdam UMC. University Medical Center)
Pacheco, Andrés (Hospital Universitari Vall d'Hebron)
Tsonas, Anissa M. (Amsterdam UMC. University Medical Center)
Mooij, Willemijn E. (Amsterdam UMC. University Medical Center)
Burgener, Alessia (Amsterdam UMC. University Medical Center)
Manrique Hehl, Tosca (Amsterdam UMC. University Medical Center)
Shrestha, Gentle S. (Tribhuvan University Teaching Hospital)
Horn, Janneke (Amsterdam UMC Research Institute)
Tuinman, Pieter R. (Amsterdam UMC. University Medical Center)
Paulus, Frederique (Amsterdam University of Applied Sciences)
Roca, Oriol (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Schultz, Marcus J. (University of Oxford)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	The COVID-19 pandemic led to local oxygen shortages worldwide. To gain a better understanding of oxygen consumption with different respiratory supportive therapies, we conducted an international multicenter observational study to determine the precise amount of oxygen consumption with high-flow nasal oxygen (HFNO) and with mechanical ventilation. A retrospective observational study was conducted in three intensive care units (ICUs) in the Netherlands and Spain. Patients were classified as HFNO patients or ventilated patients, according to the mode of oxygen supplementation with which a patient started. The primary endpoint was actual oxygen consumption; secondary endpoints were hourly and total oxygen consumption during the first two full calendar days. Of 275 patients, 147 started with HFNO and 128 with mechanical ventilation. Actual oxygen use was 4. 9-fold higher in patients who started with HFNO than in patients who started with ventilation (median 14. 2 [8. 4-18. 4] versus 2. 9 [1. 8-4. 1] L/minute; mean difference = 11. 3 [95% CI 11. 0-11. 6] L/minute; P < 0. 01). Hourly and total oxygen consumption were 4. 8-fold (P < 0. 01) and 4. 8-fold (P < 0. 01) higher. Actual oxygen consumption, hourly oxygen consumption, and total oxygen consumption are substantially higher in patients that start with HFNO compared with patients that start with mechanical ventilation. This information may help hospitals and ICUs predicting oxygen needs during high-demand periods and could guide decisions regarding the source of distribution of medical oxygen.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	The American Journal of Tropical Medicine and Hygiene, Vol. 108 (march 2023) , p. 1035-1041, ISSN 1476-1645

DOI: 10.4269/ajtmh.22-0793
PMID: 36972693

7 p, 1.1 MB

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