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Amaury Serruys

Bio: Amaury Serruys is an academic researcher. The author has contributed to research in topics: Intubation & Nasal cannula. The author has co-authored 2 publications.

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Journal ArticleDOI
TL;DR: In this article, the authors conducted a bi-centric prospective observational study of all medical transfers of patients needing high-flow nasal cannula (HFNC) with the Chambery and Angers (France) mobile emergency and intensive care service (SMUR) during the "second wave" of the COVID-19 pandemic in France.
Abstract: At the start of the COVID-19 pandemic, early intubation was recommended on the basis of worldwide observations of severe hypoxemia. However, some patients were ultimately able to benefit from high-flow nasal cannula (HFNC) and thus avoid intubation. During the "second wave" (September to December 2020 in France), some emergency departments implemented HFNC in patients with severe COVID-19. The question then arose regarding the transfer of these most serious patients to intensive care units (ICU) and of the respiratory modalities to be used during this transfer. To assess the feasibility of interhospital transfers of COVID-19 patients needing HFNC, we conducted a bi-centric prospective observational study of all medical transfers of patients needing HFNC with the Chambery and Angers (France) mobile emergency and intensive care service (SMUR) during the "second wave" of the COVID-19 pandemic in France. Analysis of these 42 patients showed no significant variation in the respiratory requirements during the transfer. Overall, 52% of patients were intubated during their stay in ICU, including three patients intubated before or during transfer. Interhospital transfer with HFNC is very high-risk, and intubation remains indicated in the most unstable patients. However, 48% of patients benefited from HFNC and were thus able to avoid intubation during their transfer and ICU stay; for these patients, intubation would probably have been indicated in the absence of available HFNC techniques.

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TL;DR: The Somme County Emergency Medical Service (SAMU80), part of AmiensPicardy University Hospital [CHU-AP], Amiens, France, studied the feasibility of transferring patients on high-flow nasal cannula (HFNC), which decreases the need for subsequent invasive ventilation in patients with hypoxemic pneumonia.
Abstract: 22 Severe forms of coronavirus disease 2019 (COVID-19) can lead to hypoxemic pneumonia and the need for treatment with high-flow nasal cannula (HFNC) oxygen therapy. This treatment decreases the need for subsequent invasive ventilation in patients with hypoxemic pneumonia. The oxygen flow in the nasal cannula is driven pneumatically or using a turbine. Oxygen and air are mixed (giving the fraction of inspired oxygen [FiO2]) and propelled at up to 80 L·min. The propelled gases must be heated and humidifi ed. HFNC system is not intended for use outside a hospital environment. The COVID-19 has been spreading quickly, and almost all countries and regions around the world have been aff ected. In France, the COVID-19 pandemic led to the saturation of intensive care units, a lack of beds, and thus the need for patient transfers. Patients on HFNC with no indication for immediate invasive ventilation cannot be transferred using conventional oxygen therapy. However, the use of invasive ventilation for interhospital transfers raises ethical questions. With a view to avoiding transfers with intubation, the Somme County Emergency Medical Service (SAMU80, part of AmiensPicardy University Hospital [CHU-AP], Amiens, France) studied the feasibility of transferring patients on HFNC.