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Background High-flow nasal cannula showed success in some coronavirus disease 2019 (COVID-19) patients. High-velocity nasal insufflation (Hi-VNI) is a refined form of high-flow nasal cannula that delivers heated and humidified gas with high velocity through a simple small-bore nasal cannula. Objective To assess the impact of early use of Hi-VNI in improving hypoxemia and respiratory distress and its effect on the length of ICU stay in COVID-19 patients presented with acute respiratory failure. Patients and methods In total, 30 patients with confirmed COVID-19 presented with respiratory failure admitted to intensive care of COVID-19 zone were recruited to the study from October 2021 to February 2022. They were categorized into two groups: early and late Hi-VNI groups according to whether the shift to Hi-VNI occurred after low-flow nasal cannula or non-rebreathing mask, respectively. Results Successful outcome was achieved in 73.3% in early Hi-VNI group versus 53.3% in late Hi-VNI group. Regarding successful outcome, the duration of Hi-VNI and ICU stay was significantly (P <0.001) lower in early Hi-VNI group. Higher inflammatory markers and lymphopenia are predictors of failure. Conclusion The early use of Hi-VNI in hypoxemic respiratory failure of COVID-19 achieved better improvement of respiratory distress, oxygenation, and shorter ICU stay. [ABSTRACT FROM AUTHOR]

Background Predicting mortality and outcome of critically ill patients is an interesting point for research, so different acuity scores, such as Acute Physiology and Chronic Health Evaluation II, Simplified Acute Physiology Score II (SAPS II), Mortality Probability Model II (MPM II), and Sequential Organ Failure Assessment (SOFA), and biochemical markers are under investigation for its assessment. Aim The aim of this study were to compare between different ICU scores, for predicting mortality and to assess validity of some biochemical markers such as C-reactive protein (CRP), neutrophil-lymphocytic ratio (NLR), platelet to lymphocyte ratio, red cell distribution width, and mean platelet volume in the assessment of ICU outcome. Patients and methods This prospective cross-sectional study included 104 patients. The patients were subdivided into survivor and nonsurvivor groups. Acute Physiology and Chronic Health Evaluation II and SAPS II scores of the patients were recorded on the first day of admission to respiratory ICU, while SOFA and MPM II scores were recorded on the first and third (SOFA72, MPM72) days of ICU admission, where both groups were compared in terms of different ICU acuity scores as well as some biochemical markers. Sensitivity and specificity of each parameter for predicting mortality were calculated. Results The nonsurvivor group included 41 (39.4%) patients. All model scores as well as CRP and NLR were significantly higher in the nonsurvivor group; SOFA72 score had the highest sensitivity of 94.8% with an area under the roc curve (AUR) of 0.94 while the MPM72 score had the highest specificity of 91% with an AUR of 0.81 with a cutoff value of 5 and16, respectively. Conclusion While SOFA72 score has the highest sensitivity, MPM72 score has the highest specificity for predicting ICU mortality. NLR and CRP values are independent prognostic factor for hospital mortality in critically ill patient. [ABSTRACT FROM AUTHOR]