High flow nasal cannula oxygen and noninvasive mechanical ventilation in management of COVID-19 patients with acute respiratory failure: a retrospective observational study

<bold>Background:</bold> High flow nasal cannula oxygen (HFNCO) is a relatively new technique used to deliver oxygen in respiratory failure patients. This retrospective study is aiming to assess the role and benefits of using HFNCO compared to non-invasive ventilation (NIV) in management of patients with acute hypoxemic respiratory failure associated with coronavirus disease 2019 (COVID-19). <bold>Results:</bold> A retrospective analysis of the files of 63 patients with COVID-19 and acute hypoxemic respiratory failure admitted to the (ICU), 37 patients received HFNCO as initial therapy, and 26 patients were primarily treated with NIV. There was no significant difference between the 2 groups in terms of baseline characteristics, laboratory tests, arterial blood gases, PaO2/FiO2 values, and vital signs. Re-assessment after 24 h of starting treatment with either HFNCO or NIV showed significant improvement (p<0.01) in the respiratory rate, heart rate, and oxygenation parameters. Success rate of HFNCO was 86.4%, endotracheal intubation with invasive mechanical ventilation was required in 10.81% of patients, and mortality rate was 2.7%. Success rate of NIV was 84.6%, endotracheal intubation rate was 11.53%, and mortality rate was 3.8%. No significant difference (P>0.05) between the 2 groups as regards the duration of treatment, rate of endotracheal intubation with invasive mechanical ventilation, and mortality rate. <bold>Conclusion:</bold> HFNCO is effective in the management of acute hypoxemic RF associated with COVID-19 with results comparable to NIV.