Table 2 Patient characteristics, management and outcomes according to high-flow nasal cannula oxygen therapy failure
Variables | No HFNC failure (n = 36) | HFNC failure (n = 78) | p value |
|---|---|---|---|
Clinical characteristics | |||
Age (years) | 65 (56–74) | 69 (61–74) | 0.41 |
SAPS-2 score | 31 (24–39) | 48 (37–70) |  < 0.001 |
SOFA score on ICU admission | 4 (3–5) | 5 (4–9) | 0.01 |
Male gender, n (%) | 26 (72) | 59 (76) | 0.87 |
Body mass index (kg/m2) | 28 (26–31) | 28 (25–30) | 0.53 |
Obesity, n(%) | 10 (28) | 21 (27) | 1.00 |
Arterial hypertension, n (%) | 19 (53) | 49 (63) | 0.42 |
Diabetes mellitus, n (%) | 11 (31) | 28 (36) | 0.73 |
Coronary artery disease, n (%) | 6 (17) | 13 (17) | 1.00 |
Stroke, n (%) | 2 (6) | 3 (4) | 1.00 |
Chronic respiratory disease, n (%) | 2 (6) | 15 (19) | 0.10 |
Chronic kidney disease, n (%) | 5 (14) | 11 (14) | 1.00 |
Cirrhosis, n (%) | 0 (0) | 2 (3) | 0.84 |
Neoplasia, n (%) | 5 (14) | 17 (22) | 0.46 |
Blood type, n (%)* | 0.83 | ||
 A | 12 (37) | 33 (42) |  |
 B | 6 (19) | 10 (13) |  |
 AB | 1 (3) | 4 (5) |  |
 O | 13 (41) | 31 (40) |  |
Second pandemic wave, n (%) | 31 (86) | 64 (82) | 0.41 |
Nosocomial COVID-19, n (%) | 2 (5) | 7 (9) | 0.80 |
CT-Scan, n (%) | 34 (94) | 71 (91) | 0.80 |
CT-Scan abnormalities (%) | 0.34 | ||
 < 10% | 0 (0) | 2 (3) |  |
 10–25% | 8 (24) | 18 (26) |  |
 25–50% | 16 (47) | 25 (35) |  |
 50–75% | 10 (29) | 20 (28) |  |
 > 75% | 0 (0) | 6 (8) |  |
Norepinephrine, n (%) | 0 (0) | 68 (87) |  < 0.001 |
Renal replacement therapy, n (%) | 2 (6) | 20 (26) | 0.01 |
Biological variables at ICU admission | |||
Lymphocytes (× 109/L) | 0.77 (0.58–1.02) | 0.61 (0.40–1.06) | 0.11 |
Fibrinogen (g/L) | 6.52 (5.54–7.12) | 5.59 (5.05–7.00) | 0.13 |
D-Dimers (µg/L) | 1094 (634–1815) | 1055 (642–1802) | 0.77 |
Protein C reactive (mg/L) | 128 (61–200) | 136 (94–180) | 0.40 |
Procalcitonin (ng/L) | 0.20 (0.10–0.55) | 0.31 (0.16–0.62) | 0.23 |
Ferritin (ng/mL) | 1066 (598–1259) | 1090 (705–2053) | 0.63 |
Interleukin-6 (pg/mL) | 32 (19–42) | 69 (21–197) | 0.07 |
Troponin (ng/L) | 15 (11–81) | 23.5 (14–42) | 0.03 |
Treatments at ICU admission | |||
Corticosteroids, n (%) | 31 (86) | 63 (81) | 0.67 |
Immunomodulatory treatments, n (%) | 2 (6) | 4 (5) | 1.00 |
Antiviral drugs, n (%) | 2 (6) | 7 (9) | 0.79 |
Low-dose thrombophylaxis, n (%) | 4 (11) | 13 (17) | 0.62 |
Enhanced intermediate-dose thrombophylaxis, n (%) | 31 (86) | 52 (67) | 0.05 |
Curative anticoagulation, n (%) | 1 (3) | 14 (18) | 0.05 |
Antibiotherapy, n (%) | 15 (42) | 43 (55) | 0.26 |
Ventilatory management | |||
6-h ROX index | 1.88 (1.46–2.10) | 1.56 (1.33–1.83) | 0.02 |
Non-invasive ventilation, n (%) | 6 (17) | 14 (18) | 1.00 |
Intubation, n (%) | 0 (0) | 78 (100) |  < 0.001 |
Neuromuscular blocker agents, n (%) | 0 (0) | 74 (95) |  < 0.001 |
Prone positioning, n (%) | 0 (0) | 61 (78) |  < 0.001 |
Number of prone positioning sessions | 0 (0–0) | 3 (2–5) | NA |
Awake prone positioning, n (%) | 17 (47) | 30 (39) | 0.50 |
Venovenous ECMO, n (%) | 0 (0) | 7 (9) | 0.15 |
Nitric oxide, n (%) | 0 (0) | 14 (18) | 0.02 |
Delays and outcomes | |||
From onset of symptoms to ICU admission (days) | 9 (7–11) | 7 (5–10) | 0.03 |
From onset of symptoms to HFNC initiation (days) | 9 (7–11) | 7 (5–10) | 0.01 |
From ICU admission to HFNC initiation (days) | 0 (0–1) | 0 (0–1) | 0.93 |
From ICU admission to intubation (days) | 0 (0–0) | 2 (1–5) |  < 0.001 |
Duration of HFNC (days) | 5 (3–9) | 2 (2–6) |  < 0.001 |
Duration of invasive mechanical ventilation (days) | 0 (0–0) | 6 (0–16) |  < 0.001 |
Tracheostomy, n (%) | 0 (0) | 16 (20) | 0.01 |
Ventilator-associated pneumonia, n (%) | 0 (0) | 63 (81) |  < 0.001 |
Pulmonary embolism, n (%) | 0 (0) | 5 (6) | 0.29 |
Pneumothorax, n (%) | 0 (0) | 4 (5) | 0.40 |
ICU length of stay (days) | 5 (3–8) | 16 (7–33) |  < 0.001 |
ICU mortality (n,%) | 4 (11) | 27 (34) | 0.02 |
In-hospital mortality, n (%) | 6 (17) | 28 (36) | 0.06 |