Case Report
Volume 3 Issue 3 - 2020
A Case of Acute Respiratory Failure with Hypercapnia Treated with Nasal High-Flow Therapy
Pierpaolo Prosperi1, Francesca Guido2, Angela D’Intino3 , Antonella Spacone1*
1Respiratory Medicine Unit, Hospital “Santo Spirito” Pescara, Italy
2Radiology Unit, Hospital “Santo Spirito” Pescara, Italy
3Emergency Unit, Hospital “Santo Spirito” Pescara, Italy
*Corresponding Author: Antonella Spacone, Respiratory Medicine Unit, Hospital “Santo Spirito” Pescara, Italy.
Received: February 17, 2020; Published: February 25, 2020


Introduction: Noninvasive ventilation (NIV) has always been considered as the firstline therapy for hypercapnic respiratory failure (HRF). Sometimes, patients are unsuited for this treatment, but there is no established alternative when they do not tolerate standard NIV. High-flow nasal cannula (HFNC) oxygen therapy has been gaining interest as an innovative respiratory support for critically ill patients, especially those with hypoxemic respiratory failure. We describe a case report of a patient with pneumonia and HRF that was treated succesfully with HFNC.

Case Report: RA, a 78-years-old Caucasian, female, ex-smoker, with a history of chronic obstructive pulmonary disease and coronary heart disease, was admitted with a diagnosis of pneumonia and secondary respiratory acidosis. In addition to being administered steroid and antibiotic therapy, the began treatment with NIV and oxygen therapy for 3 days. Despite the correction in pH, the values of the capnia continued to remain high and NIV via a face mask was no longer tolerated. High-resolution computed tomography showed the presence of bronchiectasis. Thus, we decided to initiate HFNC and after beginning, the clinical condition of patient improved and she was transferred to a rehabilitation medicine unit in room air, without support oxygen and/or NIV.

Conclusion: This clinical case underscores the effectiveness of HFNC, through a dramatic decreases in arterial carbon dioxide in a patient with COPD and bronchiectasis, who experienced acute respiratory failure that was accompanied by hypercapnia, secondary to pneumonia. 

Keywords: High-Flow Nasal Cannula; Hypercapnia; Respiratory Failure; Pneumonia


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Citation: Antonella Spacone., et al. “A Case of Acute Respiratory Failure with Hypercapnia Treated with Nasal High-Flow Therapy”. EC Clinical and Medical Case Reports 3.3 (2020): 01-06.

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