Descripción de la experiencia con el uso de cánulas nasales de alto flujo en pacientes adultos con COVID-19. Hospital Universitario San Ignacio, Bogotá D.C. 2020-2022

Introduction: The COVID-19 pandemic prompted the use of non-invasive therapies such as high-flow nasal cannula (HFNC) to manage hypoxemia, aiming to reduce the need for invasive mechanical ventilation. Objective: To describe the experience at Hospital Universitario San Ignacio with the use of HFNC in adult patients with COVID-19 and its impact on the need for orotracheal intubation and mortality. Methods: Retrospective observational study including 604 patients with confirmed COVID-19 diagnosis by RT-PCR or antigen testing. Clinical, paraclinical, and outcome variables, such as the need for intubation and mortality, were analyzed. Results: The cohort mainly consisted of male patients (62.1%) with a median age of 62 years. The most common comorbidities were hypertension (36.9%), diabetes (18.7%), and obesity (17.9%). Most patients started HFNC 53 hours after diagnosis. The ROX index decreased from 16.4 to 4.6 before intubation. Overall, 58.8% of patients required intubation; the global mortality rate was 24.2%, higher among intubated patients (31.5%) and those admitted to the ICU (26.4%). Among non-intubated patients, 86.3% survived, and 73.1% did not require admission to the intensive care unit (ICU). Conclusions: The use of HFNC may be associated with a reduced need for intubation and a higher survival rate in patients with COVID-19, particularly when implemented early in the disease course. These findings support the role of HFNC as an effective tool in managing acute respiratory failure secondary to COVID-19.