Outcome of high flow nasal cannula versus non-invasive positive pressure ventilation in acute hypoxemic respiratory failure

Abstract

Objectives
High-flow nasal cannula (HFNC) oxygen therapy is a recent technique delivering a high flow of heated and humidified gas. HFNC is simpler to use and apply than non-invasive ventilation (NIV). We conducted this study to assess the effect of high flow nasal cannula versus the conventional non-invasive positive pressure ventilation regarding escalation of respiratory support and mortality in acute hypoxemic patients.


Methods
A total of 100 patients with acute hypoxemic respiratory failure (50 for each modality HFNC and NIPPV) were closely monitored for intubation rate, ICU length of stay, and 28 days mortality.


Results

Regarding the intubation rate, there was no statistically significant difference between HFNC and NIPPV. In the HFNC group, 25 patients (50%) received invasive mechanical ventilation while 25 (50%) of others improved. In the NIPPV group, 23 patients (46%) were invasively ventilated, and 27 patients (54%) improved with
P
value 0.68. This also applies for ICU length of stay, as the mean value in the HFNC group was 8.76 while in NIPPV group it was 8.6, with
P
value of 0.7. Regarding 28-day mortality in the HFNC group, 21 (42%) patients died, and 29 (58%) patients survived. While in the NIPPV group, 19 patients (38%) died while 31 patients (62%) survived with
P
value of 0.68.



Conclusion
High flow nasal cannula can be a comparable alternative to non-invasive positive pressure ventilation in acute hypoxemic respiratory failure with no significant differences in intubation rate and mortality.