High-Flow vs. Conventional Oxygen for Severe COVID-19

January 18, 2022

“We are all human beings.  We are more common than we are different.”
– Dr. Kimberly Brown.

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Written by Cliff Freeman

Spoon Feed
Patients suffering from severe COVID-19 who are treated with high-flow oxygen nasal cannula, compared with those treated with conventional supplemental oxygen, have decreased need for mechanical ventilation and more rapid clinical recovery.

Why does this matter?
COVID-19 appears to be here to stay, at least for the foreseeable future. This means it’s time to be experts in treatment options. High-flow nasal cannula is comfortable for patients, low-risk, and provides an alternative method to deliver supplemental oxygen when compared with traditional protocols. It has become much more popular during the pandemic, and we should be familiar with evidence to support it.

High flow is the way to go
This is a randomized, open-label clinical trial performed in Emergency Departments and ICUs in which patients suffering from COVID-19 with severe features (PaO2/FIO2 < 200) were randomized to high-flow nasal cannula with heated humidified oxygen or conventional oxygen supplementation using nasal cannula or mask. Patients randomized to high-flow oxygen therapy were less likely to undergo intubation within 28 days (34.3% vs. 51% p = 0.03) and more likely to sustain clinical recovery within 28 days (77.8% vs. 71%, p = 0.047). However, there was no statistical significance in mortality between the two treatment groups.

Source
Effect of High-Flow Oxygen Therapy vs Conventional Oxygen Therapy on Invasive Mechanical Ventilation and Clinical Recovery in Patients With Severe COVID-19: A Randomized Clinical Trial. JAMA. 2021 Dec 7;326(21):2161-2171. doi: 10.1001/jama.2021.20714.