High-Flow Nasal Cannula in the Context of COVID-19: Clinical Review

Abstract

The pandemic caused by the coronavirus (COVID-19) had an impact on the healthcare system and caused a collapse in different hospital sectors. The treatment of acute hypoxemic respiratory failure (AhRF) is still under debate, and high-flow nasal cannula (HFNC) has been postulated as the first-line treatment in this scenario. Reviewing recent publications specifically addressing the application of HFNC in AhRF by COVID-19, we found 34 publications involving 4503 patients. The important outcomes reported in most publications are the success rate, i.e., avoidance of endotracheal intubation (ETI). Here we will review the evolution of HFNC during the pandemic, the departments where the therapeutics were applied, the high flow generator equipment used and its application in this context, as well as the importance of the use of the ROX index. We will also describe the clinical characteristics of the patients who received HFNC.