Ward‐delivered nasal high‐flow oxygen and non‐invasive ventilation are safe for people with acute respiratory failure: a cohort study

• DOI: 10.1111/imj.16624
• Publication Date: 2025-01-11T10:32:41Z
• Authors: Catherine Buchan; Yet Hong Khor; Rebecca Disler; Matthew T. Naughton; Natasha Smallwood
• Keywords: Interquartile range; Respiratory care; Oxygen therapy; Oxygen Saturation

Abstract Background and Aims Ward‐delivered non‐invasive respiratory supports (NIRS) (conventional oxygen therapy (COT), high‐flow nasal (HFNO), continuous positive airway pressure (CPAP) ventilation (NIV)), are often used to treat hospitalised patients with acute failure (ARF) both in high acuity general wards. This study aimed describe the processes of care adopted examine patient outcomes from a specialist, ward‐delivered NIRS service caring for people COVID‐19 wards or unit (RCU). Methods A cohort was undertaken including all consecutive admitted quaternary hospital ARF secondary requiring between 28 February 2020 18 March 2022. use, were examined. Results Six hundred sixty‐eight included, 61% male mean age 64 years (interquartile range 48–79 years). All received COT. Fifty eight percent required additional NIRS: HFNO (36.2%), CPAP (19.8%) NIV (1.9%). Eighty‐two had saturation targets documented. After implementation RCU, significantly more nurse consultant‐led prescriptions initiated ( P = 0.004) fewer review by ICU team 0.001) transfer 0.050). Forty‐nine died (7.3%), most (62.8%) being discharged directly home. Conclusion highlights that is feasible safe ARF. The combination ward RCU‐delivered particularly effective. Further research determine optimal models broader understand how these should be implemented.