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Letter to the Editor
Veno-arterial extracorporeal membrane oxygenation may be useful in critically ill COVID-19 patients with suspected cardiac injury
Eunyoung Heo, Se Jin Oh, Hyun Woo Lee, Jung-Kyu Lee, Deog Kyeom Kim, Sang-Won Park
Acute Crit Care. 2020;35(3):223-225.   Published online August 10, 2020
  • 3,979 View
  • 72 Download
Original Article
Reduction of PaCO2 by high-flow nasal cannula in acute hypercapnic respiratory failure patients receiving conventional oxygen therapy
Hyun Woo Lee, Sun Mi Choi, Jinwoo Lee, Young Sik Park, Chang-Hoon Lee, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, Sang-Min Lee
Acute Crit Care. 2019;34(3):202-211.   Published online August 31, 2019
  • 9,601 View
  • 207 Download
  • 13 Web of Science
  • 13 Crossref
AbstractAbstract PDF
It has been suggested that a high-flow nasal cannula (HFNC) could help to remove carbon dioxide (CO2) from anatomical dead spaces, but evidence to support that is lacking. The objective of this study was to elucidate whether use of an HFNC could reduce the arterial partial pressure of CO2 (PaCO2) in patients with acute hypercapnic respiratory failure who are receiving conventional oxygen (O2) therapy.
A propensity score-matched observational study was conducted to evaluate patients treated with an HFNC for acute hypercapnic respiratory failure from 2015 to 2016. The hypercapnia group was defined as patients with a PaCO2 >50 mm Hg and arterial pH <7.35.
Eighteen patients in the hypercapnia group and 177 patients in the nonhypercapnia group were eligible for the present study. Eighteen patients in each group were matched by propensity score. Decreased PaCO2 and consequent pH normalization over time occurred in the hypercapnia group (P=0.002 and P=0.005, respectively). The initial PaCO2 level correlated linearly with PaCO2 removal after the use of an HFNC (R2=0.378, P=0.010). The fraction of inspired O2 used in the intensive care unit was consistently higher for 48 hours in the nonhypercapnia group. Physiological parameters such as respiratory rate and arterial partial pressure of O2 improved over time in both groups.
Physiological parameters can improve after the use of an HFNC in patients with acute hypercapnic respiratory failure given low-flow O2 therapy via a facial mask. Further studies are needed to identify which hypercapnic patients might benefit from an HFNC.


Citations to this article as recorded by  
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    Acute and Critical Care.2024; 39(1): 61.     CrossRef
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  • Efficacy of High-Flow Nasal Cannula Oxygen Therapy in Patients with Mild Hypercapnia
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  • High-Flow Nasal Cannula Oxygen Therapy Can Be Effective for Patients in Acute Hypoxemic Respiratory Failure with Hypercapnia: a Retrospective, Propensity Score-Matched Cohort Study
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  • Impact of High-Flow Nasal Cannula on Arterial Blood Gas Parameters in the Emergency Department
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    Cureus.2020;[Epub]     CrossRef

ACC : Acute and Critical Care