[EngO3] English Session3

[EngO3-3] Current practice of high-flow nasal cannula-the pilot study

Je Hyeong Kim¹, Byun Ki Kim², Su A Kim¹, You Sang Ko³, Won Gun Kwack⁴, So Young Park⁵ (1.Department of Critical Care Medicine, Korea University Ansan Hospital, Korea, 2.Division of Pulmonology, Department of Internal Medicine, Korea University Ansan Hospital, Korea, 3.Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Korea, 4.Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University Hospital, Korea, 5.Department of Pulmonary and Critical Care Medicine, Chung Nam National University Medical Center, Korea)

[Background] High-flow nasal cannula (HFNC) is a recently developed oxygen (O2) supply device. In many hypoxemic conditions, it has been reported to improve clinical outcomes, resulting in increased use in clinical practice. The purpose of this pilot study is to examine the current practice of HFNC in Korea. [Methods] From April 1 to June 30, 2018, we retrospectively reviewed medical records of 354 adult patients who were applied HFNC in 4 university hospitals. [Results] The mean age of the patients was 70.7 years old and 64.4% was male. Most were medical patients (n=308). Among them, 174 (56.5%) were patients admitted to non-pulmonology division. The most common cause of O2 therapy was pulmonary conditions including pneumonia (64.4%). The nasal cannula was most commonly applied device prior to HFNC (37.7%). The applied locations of HFNC were in ward (43.2%), intensive care uni t(ICU, 41.5%) and emergency room (15.3%). Half and one third of cases were decided by resident and pulmonologist, respectively. Successful HFNC weaning rate was 57.6% and 71 patients (20.1%) were escalated to NIV or intubation. In multivariate analysis, PaO2 prior to HFNC was associated with escalation to NIV or intubation (p=0.006), and O2 saturation (p=0.017) and respiration rate (p=0.001) just after HFNC application were associated with death during HFNC. [Conclusion] In current, HFNC is common O2 supply device in ward and ICU, and several factors associated with HFNC failure. More precise survey is needed to examine the status of HFNC use and evaluate the factors associated with outcome of HFNC.
* This abstract was previously presented as poster in 2018 Annual Conference of Korean Academy of Tuberculosis and Respiratory Diseases.