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• W2895410260 abstract "SESSION TITLE: Critical Respiratory Care SESSION TYPE: Original Investigations PRESENTED ON: 10/08/2018 07:30 AM - 08:30 AM PURPOSE: High flow nasal cannula (HFNC) oxygen(O2) therapy delivers heated and humidified gas with flow rates up to 60 L/min. It also provides a small PEEP effect, reduces anatomical dead space, and provides a constant fraction of inspired oxygen(FiO2). It has been extensively studied in pediatric population and has lately gained popularity in adult patient population although evidence for use in critically ill adults still remains poor. Additionally, to our knowledge, evidence of its use in patients 80 years of age and above has not been assessed. We attempt to study the indications and effects of HFNC use in patients 80 years of age and above in the medical intensive care unit (MICU) of a tertiary care hospital. METHODS: 40 patients 80 years of age and above who required HFNC O2 in the MICU for more than 12 hours between 01/01/2016 and 08/01/2017 were identified. Retrospective chart review was performed and data related to HFNC O2 use was obtained. Data included age, diagnosis, indication for HFNC, duration of HFNC use, initial FiO2 and flow rate, modality of oxygenation used before and after HFNC, disposition and code status. The data was charted on a spreadsheet and analyzed by calculating percentage associated with various variables. RESULTS: Mean age of the patients was 89.025 years. Mean duration of HFNC O2 use was 5 days. Mean initial FiO2 was 45.625%. Mean initial flow rate was 42.75 L/min. Most common indication for HFNC use was hypoxemia post extubation. Most common diagnosis was sepsis due to pneumonia. 52.5%(21/40) patients were transitioned to HFNC O2 post extubation. 47.5%(19/40) were transitioned from nasal cannula(NC) or bilevel positive airway pressure ventilation (BPAP). 15%(6/40) had to be intubated and mechanically ventilated after HFNC O2 use whereas 85%(34/40) were downscaled to regular NC O2. Of the 6 intubations, 3 were re-intubations. 12.5%(5/40) patients expired whereas 87.5%(35/40) patients were discharged from the hospital. Code status for 4 patients was changed to comfort care with do not intubate(DNI) after extubation to HFNC, 2/4 were discharged and the other 2 expired. CONCLUSIONS: This study revealed a positive outcome with respect to use of HFNC O2 in patients 80 years of age and above. Majority (87.5%) of the patients were discharged from the hospital. Intubation(15%) and re-intubation rates were low after use of HFNC O2. Patients who opted for comfort care (DNR/DNI) but could not maintain optimum oxyhemoglobin saturation with NC O2 and found BPAP uncomfortable, benefitted from HFNC with respect to comfort and compliance per chart review. CLINICAL IMPLICATIONS: Elderly patients might benefit from HFNC O2 especially after liberation from mechanical ventilation. Elderly patients with hypoxemic respiratory failure who opt for comfort care but cannot maintain optimum oxyhemoglobin saturation with NC O2 and find BPAP uncomfortable could also benefit from HFNC O2 use. DISCLOSURES: No relevant relationships by Prarthna Chandar, source=Web Response No relevant relationships by Yizhak Kupfer, source=Web Response No relevant relationships by Anand Rai, source=Web Response No relevant relationships by Arjun Saradna, source=Web Response No relevant relationships by Ben Shamian, source=Web Response No relevant relationships by Shyam Shankar, source=Web Response" @default.
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• W2895410260 date "2018-10-01" @default.
• W2895410260 modified "2023-10-05" @default.
• W2895410260 title "HIGH FLOW NASAL CANNULA OXYGEN USE IN OCTOGENARIAN AND NONAGENARIAN PATIENTS: A RETROSPECTIVE ANALYSIS AMONG MICU PATIENTS" @default.
• W2895410260 doi "https://doi.org/10.1016/j.chest.2018.08.276" @default.
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