key: cord-0831909-uhhvhi3x
authors: Gupta, Neeraj; Sachdev, Anil; Gupta, Suresh; Gupta, Dhiren
title: High‐flow oxygen therapy in COVID times: Where affordability meets utility
date: 2021-02-01
journal: Pediatr Pulmonol
DOI: 10.1002/ppul.25276
sha: 657565313cdac4c93027cb74ccbba3ba0467226a
doc_id: 831909
cord_uid: uhhvhi3x

nan

High-flow oxygen therapy in COVID times: Where affordability meets utility

To the Editor, COVID-19 pandemic has put an unprecedented survival challenge to mankind. The tiny coronavirus has created mayhem across the world with colossal financial implications. Healthcare facilities have been badly affected globally despite being working at the supra-optimal potential. Almost one-third of the symptomatic patients have developed either single or multiorgan failure during the disease course. 1 4 It also enhances respiratory secretion clearance and ventilation-perfusion ratio with reduced atelectatic areas, thus helps in better oxygenation. 4 Li and colleagues have nicely summarized the aerosol dispersion distances with various available oxygen devices, lowest dispersion during HFOT as compared to non-rebreathing or venturi mask, making it a safer technique. 5 The simplicity of the procedure can allow the provision of adequate respiratory support in wards and step-down areas, thus saving the critical care beds for the sicker ones. 6 However, to avail the aforesaid advantages of HFOT, one needs to pay outstandingly. The standard Airvo 2 machine (with in-built humidifier) with a 1-year warranty costs 4330 USD (1 USD = 74 INR) to the medical establishment. Another 150 USD for the specified disposable circuit (tubing with nasal canula) will be billed to each patient individually along with the other hospital expenses. In the absence of any reliable medical insurance coverage or third-party payer system, especially in developing countries like India with per capita national annual income of 2130 USD, it is a nightmare for many to afford even this basic life-saving modality. 7 The sad state of affairs has further worsened during COVID times due to the narrowing of the income-expenditure gap, hugely contributed by the loss of livelihood for the masses.

A much economical and simple blender, attached to air and oxygen flowmeters along with an external humidifier, can serve the purpose in

Clinical characteristics of Covid-19 in New York City

Use of high-flow nasal cannula oxygen therapy in subjects with ARDS: a 1-year observational study

The impact of high-flow nasal cannula use on patient mortality and the availability of mechanical ventilators in COVID-19

High-flow nasal cannula: COVID 19 and beyond

High-flow nasal cannula for COVID-19 patients: low risk of bio-aerosol dispersion

High-flow nasal oxygen: a safe, efficient treatment for COVID-19 patients not in an ICU

World Bank. GNI per capita, Atlas method (current US $)