title: Extent of pleural effusion on chest radiograph is associated with failure of high-flow nasal cannula oxygen therapy.
abstract: OBJECTIVE
  The purpose of the study was to determine whether pleural effusion (PE) is associated with a failure of high-flow nasal cannula (HFNC) therapy.
  
  
  METHODS
  We conducted a single-center retrospective study. Seventy-three patients with acute respiratory failure given HFNC therapy between January 2012 and December 2014 were reviewed. HFNC failure was defined as intubation or noninvasive positive pressure ventilation following HFNC therapy. The numbers of quadrants with consolidation or ground glass opacity were counted on chest radiographs performed within 24 hours before starting HFNC therapy, and the PE score was calculated. PE score was the original score, verified by the computed tomographic images of some of the study patients.
  
  
  RESULTS
  Overall, 29 of 73 experienced HFNC failure. PE score was significantly greater in the HFNC failure group, but the number of quadrants with opacity was not significantly different. Age and Sequential Organ Failure Assessment (SOFA) score were significantly greater in the HFNC failure group. The PE (odds ratio, 1.49; 95% confidence interval, 1.10-2.02; P = .01) and SOFA (odds ratio, 1.33; 95% confidence interval, 1.05-1.68; P = .02) scores were independently associated with HFNC failure in multivariate analysis.
  
  
  CONCLUSIONS
  The extent of PE on chest radiograph and SOFA score were associated with HFNC failure.
authors.affiliation: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Ube, Yamaguchi, Japan. Electronic address: koga-ygc@umin.ac.jp.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Koga
authors.affiliation: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Ube, Yamaguchi, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Kaneda
authors.affiliation: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Ube, Yamaguchi, Japan.
authors.forename: Ichiko
authors.initials: I
authors.lastname: Mizuguchi
authors.affiliation: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Ube, Yamaguchi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakahara
authors.affiliation: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Ube, Yamaguchi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Miyauchi
authors.affiliation: Acute and General Medicine, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
authors.forename: Motoki
authors.initials: M
authors.lastname: Fujita
authors.affiliation: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Ube, Yamaguchi, Japan.
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Kawamura
authors.affiliation: Acute and General Medicine, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Oda
authors.affiliation: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Ube, Yamaguchi, Japan; Acute and General Medicine, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Tsuruta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057785:Catheters; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D063087:Noninvasive Ventilation / Q000379:methods*; D063305:Organ Dysfunction Scores; D010100:Oxygen / Q000008:administration & dosage; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D010996:Pleural Effusion / Q000000981:diagnostic imaging* / Q000209:etiology; D011859:Radiography; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D012131:Respiratory Insufficiency / Q000628:therapy*; D012189:Retrospective Studies; D017211:Treatment Failure
chemical_list: D010100:Oxygen
keywords: Acute respiratory failure; High-flow nasal cannula; Oxygen therapy; Pleural effusion