Clinical application of High-flow nasal cannula oxygen therapy in acute heart failure

Liu, Xiong; Wu, Rong; Lai, Liren; Lin, Jiyan

doi:10.1590/fst.40020

Cited by 3 publications

(2 citation statements)

References 38 publications

(41 reference statements)

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“…13 Due to these beneficial effects, the use of HFNO has been shown to be as efficacious as NIPPV in terms of reduction of intubation rates in patients with hypoxemic AHF, and also reduces the reintubation rates among patients at high risk of extubation failure. [14][15][16][17] However, the amount of PEEP developed by the HFNO is significantly lower than the PEEP effect produced by NPPV, in patients with AHF associated with severe pulmonary edema, NPPV (BiPAP) should be considered as a preferable therapy. 18 Invasive positive pressure ventilation with an endotracheal tube can be considered if all these measures fail.…”

Section: Mechanism Of Hypoxia In Heart Failurementioning

confidence: 99%

Oxygen Management in Heart Failure Patients

Ramachandran

Prasad

Garre

et al. 2022

Indian Journal of Clinical Cardiology

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Symptoms of heart failure (HF) should be alleviated as quickly as feasible. Apart from standard pharmacological therapy, supplementation of oxygen is lifesaving in hypoxemic (SpO2 <90% or PaO2 <60 mmHg) HF patients. For sick patients with SpO2 <85%, respiratory distress (respiratory rate >25 breaths per min) and pulmonary edema, along with oxygen administration, noninvasive positive pressure ventilation (NIPPV) methods, including BiPAP/CPAP or humidified high-flow nasal oxygen, should be tried to optimize oxygenation, reduce work of breathing and to reduce the venous return. If these noninvasive ventilatory support methods fail to improve hypoxemia, endotracheal intubation and mechanical ventilation should be instituted. Short-term mechanical circulatory support (extracorporeal membrane oxygenation) devices are reserved for cardiogenic shock patients due to advanced HF associated with reversible end-organ failure and hypoxia. These temporary mechanical circulatory support devices are also useful as a bridge to long-term mechanical circulatory support or heart transplant in end-stage HF with refractory cardiogenic shock. Even though the use of additional oxygen is a standard practice for hypoxemic patients, routine use of high concentrations of oxygen via inhalational therapy or NIPPV for normoxemic HF patients may result in hyperoxemia. Hyperoxemia has been shown to have negative hemodynamic effects like increased systemic vascular resistance, reduced cardiac index, and decreased coronary blood flow. Detailed prescription by the treating physician, careful monitoring, and meticulous titration of oxygen is essential for safe oxygen treatment for HF patients.

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Section: Mechanism Of Hypoxia In Heart Failurementioning

confidence: 99%

Oxygen Management in Heart Failure Patients

Ramachandran

Prasad

Garre

et al. 2022

Indian Journal of Clinical Cardiology

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“…This results in not requiring ICU facilities which reduces length of stay in ICU for ventilated patients and reduces staffing requirements without compromising patient care (Bice et al, 2013). Additionally, ICU and ventilator expertise are less of a requirement (Liu et al, 2021). Transportation of unstable patients is appropriate with HFNO treatments (Kedzierewicz et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

The design and devlopment of a low-cost high flow nasal oxygen device a functional analysis

Reabow¹,

Sivarasu²

2022

Medical Devices Innovation for Africa: Enabling Industrialisation

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High Flow Nasal Oxygen (HFNO) medical devices are utilised to non-invasively oxygenate Coronavirus disease 2019 (COVID-19) and acute respiratory distress syndrome (ARDS) patients with mechanisms of clinical benefit. Most recently, HFNO has proven to be effective against hypoxemic symptoms by providing a range of oxygen concentration levels (FiO2) and aims to improve patient compliance and comfort with heating and humidification of inspiratory gases. HFNO has been shown in studies to be feasible in resource-constrained settings, relying on an affordable solution to drive an increased number of supplied devices to healthcare facilities to effectively treat patients independently of intensive care units (ICU). Therefore, a Proof of Concept was developed under an iterative design approach. A full cost summary of materials was R8 100, compared to at least R45 000 for current South African market competitors. Additionally, the solution was functionally tested to determine levels of verification in technical specifications and validation in addressing clinician and patient needs. The solution achieved associated 10 - 60 l/min flow rates; stable FiO2 from 50 - 100% (with a minimum of 40%); and inspiratory gas temperatures and humidity of up to 40 oC and 90% relative humidity (RH). Further design and development need to be conducted to output a high-performing and safe medical device as guided by ISO 80601-2-90.

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Relationship between Plasma D-Dimer Level and Pulmonary Hypertension as well as Right Ventricle Dysfunction in Patient Post Pneumonia COVID-19

Christiawan,

Herminingsih,

Bahrudin

et al. 2023

TOCMJ

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Background: High rate of coagulopathy and pulmonary thromboembolism in coronavirus disease 2019 (COVID-19), which is represented by an increase in plasma D-Dimer levels is believed to be related to pulmonary hypertension (PH) and right ventricle (RV) dysfunction. Objective: To evaluate the relationship between plasma D-Dimer levels with PH and RV dysfunction assessed from transthoracic echocardiography (TTE) in patients post COVID-19 pneumonia. Methods: Observational research with a cross-sectional design. Estimated mean pulmonary arterial pressure (mPAP) was calculated from Mahan's formula obtained from pulmonary artery acceleration time (PAAT) and RV function was assessed from RV free wall strain (RV FWS), tricuspid annular plane systolic excursion (TAPSE), and fractional area change (FAC). D-Dimer levels during hospitalisation were obtained from medical records and actual D-Dimer was obtained at the time of echocardiography. Results: Total 40 patients post-COVID-19 pneumonia underwent TTE in a median of 11 days after negative PCR. There was a significant correlation between peak D-Dimer levels with mPAP (r=0.526, p<0.001), RV FWS (r=-0.506, p=0.001), TAPSE (r=-0.498, p=0.001), and FAC (r=0.447, p=0.004). Multivariate analysis found peak D-Dimer ≥4530 µg/L independently associated with PH with odds ratio (OR) 6.6, (95% CI 1.1-10; p=0.048), but not with RV dysfunction. Conclusion: Peak D-Dimer level correlates with echocardiographic parameters of RV function and mPAP in patients with COVID-19 infection. Peak D-Dimer ≥4530 µg/L might increase risk of PH, but not RV dysfunction in patient post pneumonia COVID-19.

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Clinical application of High-flow nasal cannula oxygen therapy in acute heart failure

Cited by 3 publications

References 38 publications

Oxygen Management in Heart Failure Patients

Oxygen Management in Heart Failure Patients

The design and devlopment of a low-cost high flow nasal oxygen device a functional analysis

Relationship between Plasma D-Dimer Level and Pulmonary Hypertension as well as Right Ventricle Dysfunction in Patient Post Pneumonia COVID-19

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