ArticleCritical care explorations2025
Ward-Based High-Flow Nasal Cannula Led by the Medical Emergency Team: A Pragmatic Model for Resource Stewardship.
Article in Critical care explorations, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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8 authors.
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Abstract
High-flow nasal cannula (HFNC) for acute hypoxemic respiratory failure is typically restricted to ICUs. We evaluated a ward-based, medical emergency team (MET)-supervised HFNC protocol (flow ≤ 40 L/min, Fio2 ≤ 0.40) with 2-/4-/8-hour nursing and respiratory therapist reassessments. Among 82 ward HFNC initiations (2021-2024), 38 (46%) required immediate ICU transfer (IMT) and 44 (54%) were Ward-Managed After MET (WMAM). Of WMAM patients, 18 transferred to ICU within 48 hours, and 26 remained on ward. WMAM patients accrued a median 1.46 ICU bed-days saved (interquartile range, 0.73-2.67); bootstrapped mean 1.63 (95% CI, 1.32-1.94), equivalent to 163 ICU days-saved per 100 initiations. Intubation (30% vs. 42%; p = 0.24) and 28-day mortality (32% vs. 39%; p = 0.47) were similar between WMAM and IMT; adjusted analyses were directionally consistent. Using an estimated $5,000 per ICU-day, cost avoidance was ≈$815,000 per 100 initiations. This MET-supervised model appears feasible, resource-sparing, and without apparent safety signal.
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