Penggunaan High-Flow Nasal Cannula (HFNC) pada penderita COVID-19; Sebuah tinjauan literatur

Ida Katarina(1Mail),
(1) Fakultas Kedokteran Universitas Sumatera Utara, Indonesia

Mail Corresponding Author


DOI : https://doi.org/10.30604/well.145312021

Full Text:    Language : id

Abstract


Gejala klinis dari COVID-19 bervariasi mulai dari asimptomatis sampai gejala berat. Penderita umumnya bergejala ringan atau sedang (80%). Akan tetapi, 14% dari penderita berlanjut sampai gangguan respirasi hipoksemia yang memerlukan terapi oksigen, 5% diantaranya memerlukan bantuan respirasi lanjutan. Seiring dengan meningkatnya kasus COVID-19, kebutuhan untuk intubasi dan ventilasi mekanis juga meningkat. High-flow nasal cannula (HFNC) mulai direkomendasikan sebagai lini pertama bantuan oksigenasi pada kasus gagal napas hipoksemia. HFNC dapat membersihkan dead space faring, reduksi usaha respirasi, efek PEEP (Positive End-Expiratory Pressure), pemberian fraksi oksigen inspirasi yang konstan, dan perbaikan pembersihan mukosiliar. Selain memberikan udara yang hangat dan lembab, HFNC nyaman dipakai sehingga penderita kooperatif. Penggunaan HFNC masih menjadi perdebatan dikarenakan resiko aerosolisasi dan penyebaran virus. HFNC juga tidak dapat menggantikan fungsi NIV maupun bantuan ventilasi mekanis. Indeks ROX digunakan sebagai prediktor apakah terapi HFNC berhasil atau gagal. Indeks ini membantu mencegah terjadinya intubasi terlambat.

 

 

Abstract: Clinical symptoms of COVID-19 vary from asymptomatic to severe. Symptoms are generally mild or moderate (80%). However, 14% of patients proceed to hypoxemia respiration failure that requires oxygen therapy, 5% of whom require advanced respiratory support. Along with the increasing cases of COVID-19, the need for intubation and mechanical ventilation has also increased. High-flow nasal cannula (HFNC) therapy begins to be recommended as the first line of oxygenation support in cases of hypoxemia respiratory failure. HFNC can washout the pharyngeal dead space, reduce respiration efforts, PEEP (Positive End-Expiratory Pressure) effect, provide a constant inspiring oxygen fraction, and improve mucosal cleansing. In addition to providing warm and humid air, HFNC is comfortable to wear so that patients are cooperative. The use of HFNC is still debated due to the risk of aerosolization and the spread of the virus. HFNC also cannot replace NIV or mechanical ventilation support. ROX index is used as a predictor of whether HFNC therapy is successful or not. This index helps prevent late intubation.


Keywords


covid-19; hfnc; high flow nasal cannula

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