Diaphragmatic Ultrasound Predictors of High-Flow Nasal Cannula Therapeutic Failure in Critically Ill Patients With SARS-CoV-2 Pneumonia

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dc.contributor.authorBruna, Mario
dc.contributor.authorHidalgo, Gabriela
dc.contributor.authorCastaneda, Sebastian
dc.contributor.authorGalvez, Miguel
dc.contributor.authorBravo, Diego
dc.contributor.authorBenitez, Rodrigo
dc.contributor.authorTobar, Rodolfo
dc.contributor.authorQuevedo, Jose
dc.contributor.authorRodriguez, Jose
dc.contributor.authorMurua, Camila
dc.contributor.authorMadariaga, Rafael
dc.contributor.authorBenavides, Claudia
dc.contributor.authorHuilcaman, Marcos
dc.contributor.authorMartinez, Felipe
dc.contributor.authorRetamal, Jaime
dc.contributor.authorKattan, Eduardo
dc.date.accessioned2025-01-20T20:20:08Z
dc.date.available2025-01-20T20:20:08Z
dc.date.issued2023
dc.description.abstractObjectivesHigh flow nasal cannula (HFNC) is frequently used in patients with acute respiratory failure, but there is limited evidence regarding predictors of therapeutic failure. The objective of this study was to assess diaphragmatic ultrasound criteria as predictors of failure to HFNC, defined as the need for orotracheal intubation or death. MethodsProspective cohort study including adult patients consecutively admitted to the critical care unit, from July 24 to October 20, 2020, with respiratory failure secondary to SARS-CoV-2 pneumonia who required HFNC. After 12 hours of HFNC initiation we measured ROX index (ratio of SpO(2)/FiO(2) to respiratory rate), excursion and diaphragmatic contraction speed (diaphragmatic excursion/inspiratory time) by ultrasound, both in supine and prone position. ResultsIn total, 41 patients were analyzed, 25 succeeded and 16 failed HFNC therapy. At 12 hours, patients who succeeded HFNC therapy presented higher ROX index in supine position (9.8 [9.1-15.6] versus 5.4 [3.9-6.8], P < .01), and higher PaO2/FiO(2) ratio (186 [135-236] versus 117 [103-162] mmHg, P = .03). To predict therapeutic failure, the supine diaphragmatic contraction speed presented sensitivity of 89% and a specificity of 57%, while the ROX index presented a sensitivity of 92.8% and a specificity of 75%. ConclusionsDiaphragmatic contraction speed by ultrasound emerges as a diagnostic complement to clinical tools to predict HFNC success. Future studies should confirm these results.
dc.fuente.origenWOS
dc.identifier.doi10.1002/jum.16141
dc.identifier.eissn1550-9613
dc.identifier.issn0278-4297
dc.identifier.urihttps://doi.org/10.1002/jum.16141
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/92563
dc.identifier.wosidWOS:000891902000001
dc.issue.numero6
dc.language.isoen
dc.pagina.final1284
dc.pagina.inicio1277
dc.revistaJournal of ultrasound in medicine
dc.rightsacceso restringido
dc.subjectCOVID-19 pneumonia
dc.subjectdiaphragmatic ultrasound
dc.subjecthigh flow nasal cannula
dc.subjectROX index
dc.subjectSARS-CoV-2
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleDiaphragmatic Ultrasound Predictors of High-Flow Nasal Cannula Therapeutic Failure in Critically Ill Patients With SARS-CoV-2 Pneumonia
dc.typeartículo
dc.volumen42
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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