2012 OPEN FORUM Abstracts
CHARACTERISTICS OF HIGH FLOW OXYGEN DELIVERY IN CRITICAL CARE, A REVIEW OF PATIENT DATA COLLECTION OVER A ONE YEAR PERIOD IN A TERTIARY MEDICAL CENTER.
Edward Boroda, Patrick Scanlon, Yuxiu Lei, Thomas Wold; Respiratory Care, Lahey Clinic Medical Center, Burlington, MA
BACKGROUND High flow oxygen therapy (Hi-Flo) from previous studies appears to be associated with patient comfort, less dyspnea and lower respiratory rate. Our study examines a year long pilot of Hi Flo utilization in a mixed medical and surgical ICU setting and specific patient characteristics associated with treatment success and failure. METHOD We collected data on 240 patients who received high flow oxygen therapy in our medical, surgical and cardiac intensive care units for a period of a year. Data collected included primary diagnosis, number of days on Hi Flo and intubation and extubation status. Demographic data including age, hospital LOS and discharge diagnoses were obtained utilizing DRG coding data upon discharge. Descriptive statistics was used to summarize the outcomes. Success with Hi-Flo treatment was defined as the patients without intubation and survival to discharge or extubation without reintubation. Failure of Hi-Flo was defined as patients with intubation, mortality at discharge, or extubation with reintubation RESULTS The average Hi-Flo duration was 3.04 days. 42% of patients were on mechanical ventilation. 30% patients were intubated after an average of 2-day Hi-Flo therapy. 12% of patients were extubated and stayed in ICU for an average of 3 days. 55% of total patients had successful Hi-Flo treatment and 45% of patients had failed Hi-Flo treatment. 55% of successful group and 65% of failure group were patients with diagnosis of pneumonia. 35% of successful group and 26% of failure group were patients with a diagnosis of chronic obstructive pulmonary disease (COPD). 53% of successful group and 43% of failure group were diagnosed with congestive heart failure (CHF). Higher percentages of patients discharged with diagnoses of CHF and COPD 53% and 35% respectively were associated with treatment success. Diagnoses which appeared to be associated with treatment failure included pneumonia and pneumonitis 65% and 27% respectively. CONCLUSION More than half of the total patients had a successful outcome after treated with Hi-Flo oxygen therapy. About forty percent Hi-Flo treated patients were on mechanical ventilation. One third of Hi-Flo treated patients were intubated. Further statistical analysis is warranted to confirm whether COPD and CHF patients have higher successful Hi-Flo treatment. Sponsored Research - None