the Effect of HFNC Treatment on Mortality and Length of ICU Stay in Patient With COVID-19 Pneumonia
Conditions: Coronavirus Infection, Pneumonia, Viral, Acute Respiratory Failure
Sponsor: Sisli Hamidiye Etfal Training and Research Hospital

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
THE EFFECT OF HFNC ON MORTALITY AND 
ICU STAY TIME IN ACUTE RESPIRATORY 
FAILURE DUE TO COVID-19 PNEUMONIA 
 
 
 
 
06.06.2020 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
Our study was planned retrospectively in 5 Covid Cohort intensive care units in our hospital to 
include the dates 15.03.2020 / 15.05.2020. The study started after getting approval from the 
local ethics committee of our hospital, ethics committee of the Ministry of Health . 
All patient data, accepted for Covid cohort, between 15 March and 10 May 2020, were scanned.  
In our study, patients over the age of 18 years, who were admitted to the ICU unit due to acute 
respiratory failure due to Covid 19 pneumonia, whose diagnosis was confirmed by PCR test, 
and who received a conventional oxygen therapy (COT) with a reservoir mask were included. 
Data from patients who is with ongoing primary pulmonary pathology other than Covid -19 
pneumonia, Glaskov coma score is below 12 or respiratory acidosis in the initial arterial blood 
gas were not included in the study. 
The diagnosis of Covid-19 was made by PCR (Polymerase Chain Reaction) test, and the 
diagnosis of pneumonia was made by clinical and radiological findings. Acute respiratory 
failure is defined as espite the conventional oxygen treatment applied at 4 lt / min with a 
reservoir mask, the patient's ratio of PaO2 / FiO2 (ratio of partial oxygen pressure to inhaled 
oxygen fraction) is less than 300. HFNC could not be applied to all patients because the number 
of patients admitted to the ICU was above the unit and device capacity of HFNC. A selection 
criterion has not been established for this treatment and the order of application of the patients 
has been taken into consideration. 
 
The study is divided into two groups. In the first group (group H), the data of patients 
undergoing HFNC treatment, and in group II (Group K), the data of patients who received COT 

with 
a 
reservoir 
mask 
were 
included.  
In HFNC support, the current air temperature is 31-37 degrees, the flow rate is 30-60 lt / min, 
and the FiO2 value is targeted so that saturation is 93% and above. Initially, continuous 
treatment was applied intermittently after the PaO2 / FiO2 ratio exceeded 250 and clinical well-
being 
occurred.  
In patients in Group K, fingertip saturation was targeted as 93% and above, and a COT was 
applied 
with 
a 
reservoir 
mask 
with 
a 
flow 
rate 
of 
6-15 
l 
/ 
min.  
The flow rate was calculated using the formula of FiO2 (%) = 21 + 4 * (liters / min) in patients 
undergoing COT. Noninvasive mechanical ventilation was applied to patients who could not 
be provided with adequate clinical and laboratory well-being in both groups (PaO2 / FiO2 ratio 
below 150) and invasive mechanical ventilation if this was insufficient 
 
Patient data were taken from our hospital's electronic information system and nurse observation 
records. Demographic data of patients in both groups, arterial blood gas values studied before 
treatment, PaO2 / FiO2 rates, orotracheal intubation times, intensive care hospitalization times, 
and forms of discharge from the intensive care unit (death or discharge) were recorded. Short-
term mortality was defined as deaths during ICU hospitalization or after hospitalization for up 
to 28 days.