COVID19: Role of Nasal High Flow and Non-Invasive Ventilation in Decreasing Mechanical Ventilation

Uncertainty around the risk of transmission to healthcare workers has led (in some health service organizations) to the exclusion of Nasal High Flow (NHF), and other modes of non-invasive respiratory support, from the care of patients with COVID19. Literature based on dispersion of exhaled air indicates that use of NHF is not greater than that of standard oxygen therapy via low flow nasal cannula, and can be attenuated by use of the recommended infection control precautions including PPE.

Treatment of acute hypoxemic respiratory failure in COVID19 is varied due to the novelty of the illness. Safe utilization of NHF appears to hold an essential role in patient management for: 1) decreasing the need for invasive mechanical ventilation, 2) improving outcomes in patients for whom the need for invasive mechanical ventilation would not have eventuated, 3) improving quality of life and care for patients not suited to receive mechanical ventilation, 4) supporting the transition of patients from mechanical ventilation to prevent failure and need for tracheostomy.

It is essential that consideration for the use of non-invasive respiratory support of any kind in the care of infectious patients includes rational analysis of both risk and benefit.

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Видео COVID19: Role of Nasal High Flow and Non-Invasive Ventilation in Decreasing Mechanical Ventilation канала American Thoracic Society