Changes in arterial blood gases after use of high-flow nasal cannula therapy in the ED

Jeong, Jin Hee; Kim, Dong Hoon; Kim, Sun Joo; Kang, Changwoo; Sh, Lee; Kang, Tae-Sin; Lee, Sang Bong; Jung, Sang Min; Kim, Dong Seob

doi:10.1016/j.ajem.2015.07.060

Cited by 41 publications

(39 citation statements)

References 17 publications

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“…We tested NHF at a flow rate of 35 L/min, and do not know whether higher flow rates, which may be used in clinical practice, have greater effects on PtCO 2 . This possibility is supported by the observations that increasing flow rates up to 60 L/min result in progressively higher levels of positive airway pressure and reduction in respiratory rate . The duration of the interventions was 30 min and it is possible that there may have been further reductions in PtCO 2 with the use of the NHF for longer periods of time, as may occur in the clinical setting.…”

Section: Discussionmentioning

confidence: 91%

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Physiological effects of titrated oxygen via nasal high‐flow cannulae in COPD exacerbations: A randomized controlled cross‐over trial

et al. 2017

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Section: Discussionmentioning

confidence: 91%

“…The accuracy of the TOSCA PtCO 2 monitor has been validated in a number of clinical settings, and as mentioned previously, we did not utilize repeat arterial blood gas sampling or a radial artery cannulae due to the associated risks.…”

Section: Discussionmentioning

confidence: 99%

Physiological effects of titrated oxygen via nasal high‐flow cannulae in COPD exacerbations: A randomized controlled cross‐over trial

et al. 2017

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“…NHF changes respiratory patterns leading to a reduced breathing rate, altered and in most cases increased tidal volume, a small increase in airway pressure and a reduction in the work of breathing . In addition, preliminary data are available that demonstrate a potential effectiveness in decreasing hypercapnia …”

Section: Results Of Different Studies Documented Decrease In Hypercapmentioning

confidence: 99%

“…So far, most RCTs exploring the use of NHF in acute respiratory failure have excluded hypercapnic patients . Only a few smaller studies and case reports with hypercapnic patients have been reported . The effect on decarboxylation varies significantly as do study conditions.…”

Section: Results Of Different Studies Documented Decrease In Hypercapmentioning

confidence: 99%

“…6,7 In addition, preliminary data are available that demonstrate a potential effectiveness in decreasing hypercapnia. [6][7][8][9][10][11] In this issue of Respirology, Pilcher et al 12 published a study of NHF use in patients with an acute exacerbation of COPD (AECOPD). The investigators prospectively evaluated the influence of titrated oxygen via NHF in a single-centre randomized crossover trial versus low flow oxygen from standard nasal prongs (SNPs).…”

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confidence: 99%

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NHF and hypercapnia: How brief can you look?

Bräunlich¹,

Wirtz²

2017

Respirology

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Comparison of high‐flow nasal cannula oxygen therapy and non‐invasive ventilation as first‐line therapy in respiratory failure: a multicenter retrospective study

Koga

Kaneda

Fujii

et al. 2019

Acute Medicine & Surgery

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To identify which subgroups of respiratory failure could benefit more from high-flow nasal cannula oxygen therapy (HFNC) or non-invasive ventilation (NIV). Methods: We undertook a multicenter retrospective study of patients with acute respiratory failure (ARF) who received HFNC or NIV as first-line respiratory support between January 2012 and December 2017. The adjusted odds ratios (OR) with 95% confidence intervals (CI) for HFNC versus NIV were calculated for treatment failure and 30-day mortality in the overall cohort and in patient subgroups. Results: High-flow nasal cannula oxygen therapy and NIV were used in 200 and 378 patients, and the treatment failure and 30-day mortality rates were 56% and 34% in the HFNC group and 41% and 39% in the NIV group, respectively. The risks of treatment failure and 30-day mortality were not significantly different between the two groups. In subgroup analyses, HFNC was associated with increased risk of treatment failure in patients with cardiogenic pulmonary edema (adjusted OR 6.26; 95% CI, 2.19-17.87; P < 0.01) and hypercapnia (adjusted OR 3.70; 95% CI, 1.34-10.25; P = 0.01), but the 30-day mortality was not significantly different in these subgroups. High-flow nasal cannula oxygen therapy was associated with lower risk of 30-day mortality in patients with pneumonia (adjusted OR 0.43; 95% CI, 0.19-0.94; P = 0.03) and in patients without hypercapnia (adjusted OR 0.51; 95% CI, 0.30-0.88; P = 0.02). Conclusion: High-flow nasal cannula oxygen therapy could be more beneficial than NIV in patients with pneumonia or non-hypercapnia, but not in patients with cardiogenic pulmonary edema or hypercapnia.

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Changes in arterial blood gases after use of high-flow nasal cannula therapy in the ED

Cited by 41 publications

References 17 publications

Physiological effects of titrated oxygen via nasal high‐flow cannulae in COPD exacerbations: A randomized controlled cross‐over trial

Physiological effects of titrated oxygen via nasal high‐flow cannulae in COPD exacerbations: A randomized controlled cross‐over trial

NHF and hypercapnia: How brief can you look?

Comparison of high‐flow nasal cannula oxygen therapy and non‐invasive ventilation as first‐line therapy in respiratory failure: a multicenter retrospective study

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