Physicians at the University of Chicago Medicine are swapping ventilators and intubation for high-flow nasal cannulas and prone positioning to treat some patients with COVID-19. Their results have been encouraging.
High-flow nasal cannulas are noninvasive nasal prongs placed below the nostrils that blow warm, humidified oxygen into the nose and lungs. Emergency department physicians at the University of Chicago Medicine have treated dozens of COVID-19 patients with high-flow nasal cannulas rather than ventilators. After 10 days, only one patient required intubation.
This treatment combination has helped to avoid intubations and has decreased the rate of poor outcomes. "The proning and the high-flow nasal cannulas combined have brought patient oxygen levels from around 40 percent to 80 percent and 90 percent, so it's been fascinating and wonderful to see," Thomas Spiegel, M.D., medical director of the University of Chicago Medicine Emergency Department, said in a statement.
High-flow nasal cannulas are not without risks. Because they blow air out, they convert the COVID-19 virus into a spray in the air. Therefore, it is essential staff have proper personal protective equipment, negative pressure patient rooms and anterooms in front of the patient rooms where staff can change in and out of safety gear to avoid contamination.