Skip Navigation
Skip to contents

ACC : Acute and Critical Care

OPEN ACCESS
SEARCH
Search

Articles

Page Path
HOME > Acute Crit Care > Volume 38(4); 2023 > Article
Editorial
CPR/Resuscitation
Effect of combined reservoir mask oxygenation and high-flow nasal cannula in COVID-19 pneumonia
Dowan Kimorcid
Acute and Critical Care 2023;38(4):507-508.
DOI: https://doi.org/10.4266/acc.2023.01480
Published online: November 24, 2023

Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea

Corresponding author: Dowan Kim Department of Thoracic and Cardiovascular surgery, Chonnam National University Hospital, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea Tel: +82-62-220-6546 Fax: +82-62-227-1636 E-mail: maskjoa@naver.com
• Received: November 10, 2023   • Accepted: November 10, 2023

Copyright © 2023 The Korean Society of Critical Care Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • 624 Views
  • 25 Download
The emergence of coronavirus disease 2019 (COVID-19) has created unprecedented challenges in respiratory care, necessitating the exploration of novel therapeutic interventions. Because the disease suddenly emerged and spread at a very rapid pace, numerous attempts were made to find the most appropriate respiratory support treatment [1]. Noninvasive respiratory support with reservoir mask oxygenation is usually considered the first-line choice for acute hypoxemic respiratory failure with COVID-19 pneumonia. A high-flow nasal cannula (HFNC) provides humidified and heated oxygen with increased tidal volume and end expiratory volume. In contrast, HFNC offers decreased dead space, respiratory rate, and work of breathing [2].
In this issue of Acute and Critical Care, Gur et al. [3] reported that dual oxygenation of reservoir mask and HFNC lowered 30-day mortality in patients with COVID-19 pneumonia. The value of this study is that addition of a reservoir mask to HFNC has been shown as one potential treatment option for COVID-19 pneumonia patients with hypoxemia. Although this study was retrospective and not randomized, it demonstrated its worth through success despite a propensity of variables such as gender, background diagnoses, laboratory findings, vital signs, and total administrated dose of glucocorticoids.
However, there was no significant difference in secondary outcomes and use of dual respiratory support modalities. Additionally, there are concerns that HFNC may increase the risk of cross-infection among healthcare providers and patients via aerosol and contamination of the HFNC circuit [4]. While the benefits of combined HFNC and reservoir mask oxygenation are compelling, high-level evidence supporting dual oxygenation remains limited [1]. Combined treatment of dual oxygenation presents a nuanced strategy in the management of COVID-19 pneumonia-related hypoxemic respiratory failure. Robust clinical trials are essential to establish its safety and efficacy in diverse patient populations.
Nevertheless, the combination of reservoir mask oxygenation and HFNC allows flexibility in adapting to the dynamic clinical course of COVID-19 pneumonia [5]. This enhanced oxygenation has the potential to alleviate hypoxemic respiratory failure more effectively than either therapy alone. The ability to adjust oxygen delivery based on individual patient needs may enhance treatment efficacy [6]. The potential advantages in terms of oxygenation and patient comfort, including resource implications, require further empirical validation [7]. During the pandemic, medical staff around the world experienced difficulties due to COVID-19, and an even more serious crisis may occur in the future. Consensus guidelines for application of equivalence methodologies when treating COVID-19 with different phenotypes are under debate [8]. Continued research is essential to elucidate the true benefits and risks of this dual modality and to guide clinicians to optimize respiratory support for affected patients, even if only to guard against evolved forms of infection

CONFLICT OF INTEREST

Dowan Kim is an editorial board member of the journal but was not involved in the peer reviewer selection, evaluation, or decision process of this article. No other potential conflict of interest relevant to this article was reported.

FUNDING

None.

ACKNOWLEDGMENTS

None.

  • 1. Marini JJ, Gattinoni L. Management of COVID-19 respiratory distress. JAMA 2020;323:2329-30.ArticlePubMed
  • 2. Whittle JS, Pavlov I, Sacchetti AD, Atwood C, Rosenberg MS. Respiratory support for adult patients with COVID-19. J Am Coll Emerg Physicians Open 2020;1:95-101.ArticlePubMedPMCPDF
  • 3. Gur I, Zalts R, Dotan Y, Hussain K, Neuberger A, Fuchs E. Combining reservoir mask oxygenation with high-flow nasal cannula in the treatment of hypoxemic respiratory failure among patients with COVID-19 pneumonia: a retrospective cohort study. Acute Crit Care 2023;48:435-41.ArticlePDF
  • 4. Remy KE, Lin JC, Verhoef PA. High-flow nasal cannula may be no safer than non-invasive positive pressure ventilation for COVID-19 patients. Crit Care 2020;24:169. ArticlePubMedPMCPDF
  • 5. Burnim MS, Wang K, Checkley W, Nolley EP, Xu Y, Garibaldi BT. The effectiveness of high-flow nasal cannula in coronavirus disease 2019 pneumonia: a retrospective cohort study. Crit Care Med 2022;50:e253-62.ArticlePubMedPMC
  • 6. Franco C, Facciolongo N, Tonelli R, Dongilli R, Vianello A, Pisani L, et al. Feasibility and clinical impact of out-of-ICU noninvasive respiratory support in patients with COVID-19-related pneumonia. Eur Respir J 2020;56:2002130. ArticlePubMedPMC
  • 7. Nair PR, Haritha D, Behera S, Kayina CA, Maitra S, Anand RK, et al. Comparison of high-flow nasal cannula and noninvasive ventilation in acute hypoxemic respiratory failure due to severe COVID-19 pneumonia. Respir Care 2021;66:1824-30.ArticlePubMed
  • 8. Gattinoni L, Chiumello D, Caironi P, Busana M, Romitti F, Brazzi L, et al. COVID-19 pneumonia: different respiratory treatments for different phenotypes? Intensive Care Med 2020;46:1099-102.ArticlePubMedPMCPDF

Figure & Data

References

    Citations

    Citations to this article as recorded by  

      • PubReader PubReader
      • ePub LinkePub Link
      • Cite
        CITE
        export Copy
        Close
        Download Citation
        Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

        Format:
        • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
        • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
        Include:
        • Citation for the content below
        Effect of combined reservoir mask oxygenation and high-flow nasal cannula in COVID-19 pneumonia
        Acute Crit Care. 2023;38(4):507-508.   Published online November 24, 2023
        Close
      • XML DownloadXML Download
      We recommend
      Related articles

      ACC : Acute and Critical Care