A Systematic Review of the High-flow Nasal Cannula for Adult Patients

Helviz, Yigal; Einav, Sharon

doi:10.1007/978-3-319-73670-9_15

Cited by 31 publications

(51 citation statements)

References 46 publications

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“…Other applicable settings for HFNC include post-extubation support, postoperative respiratory failure, intubation support, tracheostomy weaning, and support of hypoxemic patients during fiberoptic bronchoscopy. 12 CO poisoning is treated with high levels of supplemental oxygen in an effort to displace CO from hemoglobin, other heme-containing molecules, and other sites of CO binding. 13,14 This is typically realized clinically by the decrease in time that it takes to eliminate CO from hemoglobin in the peripheral circulation.…”

Section: Discussionmentioning

confidence: 99%

Carbon Monoxide Poisoning Effectively Treated with High-flow Nasal Cannula

Lee

Salhanick²

2019

Clinical Practice and Cases in Emergency Medicine

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Carbon monoxide (CO) poisoning is typically treated by administration of oxygen via non-rebreather mask (NRB). High-flow nasal cannula (HFNC) is an alternative to NRB in a variety of disease states. We report a case of the novel use of HFNC in the treatment of acute CO poisoning. A 29-year-old man presented with a carboxyhemoglobin (COHb) level of 29.8%. He was treated with HFNC, and COHb levels declined to 5.4% in 230 minutes. Given several theoretical advantages of HFNC relative to NRB, HFNC is a potential option for use in the treatment of CO poisoning.

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Section: Discussionmentioning

confidence: 99%

Carbon Monoxide Poisoning Effectively Treated with High-flow Nasal Cannula

Lee

Salhanick²

2019

Clinical Practice and Cases in Emergency Medicine

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“…Pham et al have shown the improvement of thoraco-abdominal synchrony with consecutive decrease in work of breathing and the reduction of breathing frequencies when HFNC devices are used 12 . Th e use of high fl ows washes out the carbon dioxide (CO2) from patients' airways and enriches the gas with oxygen 5 .…”

Section: Benefitsmentioning

confidence: 99%

“…Corley et al have shown that HFNC oxygen therapy can be use in perioperative period to reduce the risk of atelectasis in obese patients and to improve oxygenation 14 . Due to the fact that the gas delivered by HFNC devices is warmed and humidifi ed, patients organism are using less energy for conditioning the inspired air 5 . In addition, the patients' respiratory clearance is more effi cient because they are able to expel secretions because the cannula only occupies the nose 13 .…”

Section: Benefitsmentioning

confidence: 99%

“…Hypoxemia is one of the most encountered situation in hospitalised patients and the need for supplemental oxygen therapy is very common. It can be delivered in the form of low fl ow nasal cannula (LFNC) oxygen therapy or high fl ow nasal cannula (HFNC) oxygen therapy 5 . All the HFNC devices permit the handling of two delivered parameters: the gas fl ow rate and the oxygen percentage.…”

Section: Introductionmentioning

confidence: 99%

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The importance of high flow nasal cannula (HFNC) oxygen therapy

Ţigliş¹,

Neagu²,

Diaconu³

et al. 2019

Rev. Med. Mod.

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High flow nasal cannula (HFNC) oxygen therapy devices are used on a daily-basis in many intensive care units and postoperative wards. Such a device deliver a mixture of air and oxygen, warmed, humidifi ed, with gas flow between 20-60 L/min, and inspired oxygen fraction between 0.21-1. Therefore, it improves oxygenation, decreases dead space, washes out the carbon dioxide (CO2) from patients' airways, improves thoraco-abdominal synchrony and decreases the work of breathing. Studies have shown effi cacy of HFNC oxygen therapy use for acute hypoxemic respiratory failure, for patients with exacerbations of chronic pulmonary diseases, after extubation in order reduce the need for mechanical ventilation, in perioperative period to prevent atelectasis and in palliative care, in order to reduce breathlessness. It isn`t feasible for patients with severe altered neurological status, facial trauma, basal skull fracture, complete airway obstruction or epistaxis. There are no standardized recommendation for the use or contraindication of HFCN oxygen therapy. The weaning is realised according with patients' tolerance, oxygen saturation, respiratory and heart rates.

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“…The heated and humidified high-flow nasal cannula (HFNC) has become an increasingly popular choice of therapy due to the potential complications of invasive ventilation [1,2] and the frequent uncomfortable or lifethreatening adverse effects that are produced in noninvasive ventilation (NIV) [3]. The HFNC allows modification of only two variables: the percentage of oxygen being delivered and the rate of gas flow [4]. Numerous well-designed studies have been conducted into the use of the HFNC in the treatment of critically ill patients, and HFNC is now widely used in the treatment of patients with various diagnoses including acute hypoxemic respiratory failure or acute respiratory distress syndrome (ARDS) [5,6], and is used in post-extubation treatment [7][8][9], post-cardiothoracic surgery respiratory distress [10,11], and respiratory compromise induced by heart failure [12,13].…”

Section: Introductionmentioning

confidence: 99%

Simultaneous reduction of flow and fraction of inspired oxygen (FiO2) versus reduction of flow first or FiO2 first in patients ready to be weaned from high-flow nasal cannula oxygen therapy: study protocol for a randomized controlled trial (SLOWH trial)

Kim

Lee

Cho

et al. 2020

Trials

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Background High-flow nasal cannula (HFNC) oxygen therapy has been widely used in critically ill patients. Despite the effectiveness of HFNC as a treatment, optimal methods to withdraw HFNC after recovery from preexisting conditions have not been investigated to date. In this study, we will evaluate the safety and efficacy of simultaneous reduction of flow and fraction of inspired oxygen (FiO2) compared with sequential reduction of either flow first or FiO2 reduction first in patients with HFNC. Methods/design This is a prospective, investigator-initiated, randomized controlled trial with three experimental intervention groups. A total of 100 adult patients receiving HFNC and satisfying weaning criteria will be enrolled and randomly assigned to one of the following groups: flow reduction (FR) first, FiO2 reduction (OR) first, or simultaneous reduction (SR). In the FR group, flow will be reduced first by 10 L/min/h. When it reaches 20 L/min, FiO2 will then be reduced by 0.1 /h until it reaches 0.3. In the OR group, the FiO2 will be gradually reduced first by 0.1 /h until it reaches 0.3, then flow will be reduced by 10 L/min until it reaches 20 L/min. Finally, in the SR group, both the flow and FiO2 will be gradually reduced simultaneously by 10 L/min and 0.1/h, respectively. Weaning will proceed only when patients satisfy the weaning criteria at every weaning point. When the HFNC weaning-off targets are reached (20 L/min and 0.3 for flow and FiO2, respectively), the patient will be transferred to conventional oxygen therapy (mainly low-flow nasal prongs). The primary outcome is the time to successful weaning from HFNC for 24 h. Secondary outcomes will include the success or failure rate in weaning off HFNC and changes in arterial blood gas analyses, intolerance rate, length of hospital stay, and in-hospital mortality. Discussion This study will be the first clinical trial to investigate the safety and efficacy of three different methods of weaning in adult patients receiving HFNC. Once this study is completed, we expect to be able to suggest the better strategy for withdrawal of HFNC based on the results. Trial registration ClinicalTrials.gov, NCT03845244. Registered on 19 February 2019.

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A Systematic Review of the High-flow Nasal Cannula for Adult Patients

Cited by 31 publications

References 46 publications

Carbon Monoxide Poisoning Effectively Treated with High-flow Nasal Cannula

Carbon Monoxide Poisoning Effectively Treated with High-flow Nasal Cannula

The importance of high flow nasal cannula (HFNC) oxygen therapy

Simultaneous reduction of flow and fraction of inspired oxygen (FiO2) versus reduction of flow first or FiO2 first in patients ready to be weaned from high-flow nasal cannula oxygen therapy: study protocol for a randomized controlled trial (SLOWH trial)

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