TY - JOUR
T1 - Oxygen Consumption with High-Flow Nasal Oxygen versus Mechanical Ventilation—An International Multicenter Observational Study in COVID–19 Patients (PROXY–COVID)
AU - Botta, Michela
AU - Caritg, Oriol
AU - van Meenen, David M.P.
AU - Pacheco, Andrés
AU - Tsonas, Anissa M.
AU - Mooij, Willemijn E.
AU - Burgener, Alessia
AU - Hehl, Tosca Manrique
AU - Shrestha, Gentle S.
AU - Horn, Janneke
AU - Tuinman, Pieter R.
AU - Paulus, Frederique
AU - Roca, Oriol
AU - Schultz, Marcus J.
N1 - with supplementary file.
PY - 2023/5/3
Y1 - 2023/5/3
N2 - The COVID–19 pandemic led to local oxygen shortages worldwide. To gain a better understanding of oxygen consumption with different respiratory supportive therapies, we conducted an international multicenter observational study to determine the precise amount of oxygen consumption with high-flow nasal oxygen (HFNO) and with mechanical ventilation. A retrospective observational study was conducted in three intensive care units (ICUs) in the Netherlands and Spain. Patients were classified as HFNO patients or ventilated patients, according to the mode of oxygen supplementation with which a patient started. The primary endpoint was actual oxygen consumption; secondary endpoints were hourly and total oxygen consumption during the first two full calendar days. Of 275 patients, 147 started with HFNO and 128 with mechanical ventilation. Actual oxygen use was 4.9-fold higher in patients who started with HFNO than in patients who started with ventilation (median 14.2 [8.4–18.4] versus 2.9 [1.8–4.1] L/minute; mean difference 5 11.3 [95% CI 11.0–11.6] L/minute; P, 0.01). Hourly and total oxygen consumption were 4.8-fold (P, 0.01) and 4.8-fold (P, 0.01) higher. Actual oxygen consumption, hourly oxygen consumption, and total oxygen consumption are substantially higher in patients that start with HFNO compared with patients that start with mechanical ventilation. This information may help hospitals and ICUs predicting oxygen needs during high-demand periods and could guide decisions regarding the source of distribution of medical oxygen.
AB - The COVID–19 pandemic led to local oxygen shortages worldwide. To gain a better understanding of oxygen consumption with different respiratory supportive therapies, we conducted an international multicenter observational study to determine the precise amount of oxygen consumption with high-flow nasal oxygen (HFNO) and with mechanical ventilation. A retrospective observational study was conducted in three intensive care units (ICUs) in the Netherlands and Spain. Patients were classified as HFNO patients or ventilated patients, according to the mode of oxygen supplementation with which a patient started. The primary endpoint was actual oxygen consumption; secondary endpoints were hourly and total oxygen consumption during the first two full calendar days. Of 275 patients, 147 started with HFNO and 128 with mechanical ventilation. Actual oxygen use was 4.9-fold higher in patients who started with HFNO than in patients who started with ventilation (median 14.2 [8.4–18.4] versus 2.9 [1.8–4.1] L/minute; mean difference 5 11.3 [95% CI 11.0–11.6] L/minute; P, 0.01). Hourly and total oxygen consumption were 4.8-fold (P, 0.01) and 4.8-fold (P, 0.01) higher. Actual oxygen consumption, hourly oxygen consumption, and total oxygen consumption are substantially higher in patients that start with HFNO compared with patients that start with mechanical ventilation. This information may help hospitals and ICUs predicting oxygen needs during high-demand periods and could guide decisions regarding the source of distribution of medical oxygen.
UR - https://pure.hva.nl/ws/files/46286064/tpmd220793.SD1.pdf
UR - http://www.scopus.com/inward/record.url?scp=85152577540&partnerID=8YFLogxK
U2 - https://doi.org/10.4269/ajtmh.22-0793
DO - https://doi.org/10.4269/ajtmh.22-0793
M3 - Article
C2 - 36972693
SN - 0002-9637
VL - 108
SP - 1035
EP - 1041
JO - American journal of tropical medicine and hygiene
JF - American journal of tropical medicine and hygiene
IS - 5
ER -