Groote Schuur Hospital and a number of other facilities will focus on ‘high-flow nasal oxygen’ or ‘high-flow nasal cannula oxygenation’ (HFNCO) as an effective method to assist in treating COVID-19 patients.

Speaking during a live digiconference today [June 4], Dr Keith Cloete, Head of the Western Cape Department of Health explained that the use of high-flow nasal oxygen has helped shape the orientation of the hospital going forward.

Providing oxygen to COVID-19 patients has shown great signs of helping to treat the virus. The need to explore safer forms of respiratory support devices has arisen after reported issues with mechanical ventilation.

Reports from across the world suggest that mechanical ventilation has had negative effects on the health of COVID-19 patients as it is invasive, and doctors are thus moving away from relying on it.

High-flow nasal cannula oxygenation (HFNCO) has now become a potential answer in treating acute respiratory failure, as it is much less invasive.

HFNCO is an oxygen supply system that can deliver humidified and heated oxygen at a rate of up to 60 litres per minute.

In a paper titled ‘High-Flow Nasal Cannula Oxygenation Revisited In COVID-19‘, various authors write that HFNCO has many benefits.

“The physiological benefits of HFNCO are improved oxygenation, decreased anatomical dead space, decreased metabolic demand of breathing, decreased production of carbon dioxide, superior comfort and improved work of breathing, positive nasopharyngeal and tracheal airway pressure and better secretion clearance.”

The authors conclude that HFNCO could be an effective form of treatment for COVID-19-associated acute respiratory failure, particularly for patients with mild to moderate acute respiratory distress syndrome. It is thus positioned as a viable initial alternative to mechanical ventilation.

During the press conference Dr Cloete said, early into the COVID-19 pandemic Tygerberg Hospital placed seven coronavirus patients onto high-flow nasal oxygen. Six of the seven patients recovered.

Since then, 114 patients have been presented to the critical care platform and 70% met the criteria for high-flow nasal oxygen. A confirmed 70% of those put on high-flow nasal oxygen recovered.

As a result, more hospitals will now focus on high-flow nasal oxygen in treating COVID-19 patients. The Department is already ordering more equipment for Groote Schuur and other hospitals to administer this response.

“We believe this will be a critical game changer,” said Cloete.

The equipment has become highly sought-after internationally, however, and is therefore in short supply.

During the digiconference, Cloete also announced that the Department have readjusted their provisions for the expected peak, and plan to add 2 227 acute beds across the various COVID-19 care facilities in the Western Cape.

Picture: Pixabay

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