TIRUCHY: When the COVID-19 pandemic began, there was panic over the lack of sufficient ventilators at hospitals across the country. But with the passage of time, doctors have come to realise that high flow nasal oxygen (HFNO) may be preferable in treating COVID-19 patients with respiratory failure.
Tiruchy, which has witnessed a surge in cases and deaths in the past three weeks, is seeing the benefits of HFNO. Doctors are using it to treat respiratory failure in COVID-19 patients instead of starting them on mechanical ventilation.
So far, 40 patients have recovered with the help of HFNO at Tiruchy’s Mahatma Gandhi Memorial Government Hospital (MGMGH), said the Dean, Dr K Vanitha. Private hospitals in Tiruchy are also using this to treat COVID-19 patients.
“There are three stages - one is the normal oxygen mask, second is the HFNO and then we go for invasive ventilation. This is quite new in India. It is simple and cheaper than a ventilator. It is a bridge between the oxygen mask and ventilator and is giving much better results for COVID patients,” said Dr Vijaya Kanna, COVID Nodal Officer, SRM Hospital.
Previously, doctors would start a patient on ventilator if the normal oxygen mask didn’t work.
Initially, two patients who were kept on ventilation in Tiruchy GH did not survive. Similarly, private hospitals also saw no luck with mechanical ventilation.
Doctors said that in the normal oxygen mask, a maximum of 10-15 litres of oxygen are given per minute. With HFNO, 60 litres of oxygen are given per minute. A machine connected to a tube attached to the nose provides oxygen, which is non-invasive.
“It helps the patient breathe. It pushes breathable oxygen at a high flow, hence the name. The data from foreign countries about HFNO is very positive,” added Dr Kanna.
HFNO can be used on patients who are not very critical, are conscious, and can breathe.
“Among COVID patients, there is a section who need increased oxygen requirement. For such patients, HFNO is more comfortable. It meets the patient’s demands and helps in breathing in and out easily. The oxygen mask is uncomfortable,” said Dr Saravanan, HOD-Critical Care, Kauvery Hospitals.
The doctor added that they watch the patient for an hour or two. If the patient feels better in 1-2 hours, they continue the treatment.
“We can say that 30-40% patients have improved with HFNO. Remember, any form of ventilation is a supportive therapy. The patient’s lungs must improve for us to remove the ventilation. If a patient is conscious and blood pressure is okay, then HFNO works very well. If 5% of patients need ventilation, we can say that 2-3% will recover with HFNO,” added Dr Saravanan.
If a patient doesn’t improve with HFNO, then he or she is switched to a ventilator.
“Instead of directly intubating patients who are in respiratory distress, HFNO is being used. It does not carry a risk of infection which a ventilator does. It is very safe. We have 12 machines currently,” said Dean of MGMGH, Dr K Vanitha.
Doctors also add that, with ventilators, survival rates are poor. Hence, HFNO is being preferred.