High flow nasal cannulae oxygen therapy in acute‐moderate hypercapnic respiratory failure

Lee, Myoung Kyu; Choi, Jaehwa; Park, Bonil; Kim, Bumjoon J.; Lee, Seok Jeong; Kim, Sang-Ha; Yong, Suk Joong; Choi, Eun Hee; Lee, Won Yeon

doi:10.1111/crj.12772

Cited by 102 publications

(143 citation statements)

References 39 publications

Supporting

Mentioning

132

Contrasting

Unclassified

Order By: Relevance

“…This finding agrees with the subgroup analysis of hypercapnia patients in their retrospective study of HFNC versus NIV for postextubation by Yoo et al (). In the recently published prospective study, Lee et al () reported the comparison of HFNC and NIV in COPD exacerbation with moderate hypercapnic acute respiratory failure (pH 7.25–7.35). They found that the 30‐day intubation rate and mortality were similar and patients’ ABGs were not significantly different between the two groups after 6 and 24 hr, which is consistent with our results.…”

Section: Discussionmentioning

confidence: 99%

Comparison of high flow nasal cannula with noninvasive ventilation in chronic obstructive pulmonary disease patients with hypercapnia in preventing postextubation respiratory failure: A pilot randomized controlled trial

Jing

Dong

et al. 2019

Research in Nursing & Health

View full text Add to dashboard Cite

High flow nasal cannula (HFNC) has been shown to improve extubation outcomes in patients with hypoxemia, but the role of HFNC in weaning patients with chronic obstructive pulmonary disease (COPD) with hypercapnia from invasive ventilation is unclear. We compared the effects of HFNC to noninvasive ventilation (NIV) on postextubation vital signs and arterial blood gases (ABGs) among patients with COPD. Other outcomes included comfort scores, need for bronchoscopy, use of pulmonary medications, and chest physiotherapy. Forty‐two COPD patients who had persistent hypercapnia at extubation were assigned randomly to receive HFNC (22) or NIV (20). Twenty patients in each group were enrolled for per‐protocol analysis with regard to primary outcomes. Vital signs and ABGs before extubation were similar between groups. At 3 hr after extubation, pH in the NIV group was lower than HFNC group (7.42 ± 0.06 vs. 7.45 ± 0.05, p = 0.01). At 24 hr after extubation, patients’ mean arterial pressure (82.97 ± 9.04 vs. 92.06 ± 11.11 mmHg, p = 0.05) and pH (7.42 ± 0.05 vs. 7.46 ± 0.03, p = 0.05) in the NIV group were lower than in the HFNC group. No significant differences were found at 48 hr after extubation. In the HFNC group, comfort scores were better (3.55 ± 2.01 vs. 5.15 ± 2.28, p = 0.02) and fewer patients needed bronchoscopy for secretion management within 48 hr after extubation (2/22 vs. 9/20, p = 0.03). HFNC is a potential alternative to NIV to wean hypercapnic COPD patients with regard to vital signs and ABGs, HFNC improved patients’ comfort and secretion clearance.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of high flow nasal cannula with noninvasive ventilation in chronic obstructive pulmonary disease patients with hypercapnia in preventing postextubation respiratory failure: A pilot randomized controlled trial

Jing

Dong

et al. 2019

Research in Nursing & Health

View full text Add to dashboard Cite

show abstract

“…Compared with standard oxygen therapy, HFNO reduces the need for intubation (42). Patients with hypercapnia (exacerbation of obstructive lung disease, cardiogenic pulmonary oedema), hemodynamic instability, multiorgan failure, or abnormal mental status should generally not receive HFNO, although emerging data suggest that HFNO may be safe in patients with mild-moderate and non-worsening hypercapnia (42,43,44). Patients receiving HFNO should be in a monitored setting and cared for by experienced personnel capable of performing endotracheal intubation in case the patient acutely deteriorates or does not improve after a short trial (about 1 hour).…”

Section: Remarkmentioning

confidence: 99%

Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)

Alhazzani

Møller

Arabi

et al. 2020

Critical Care Medicine

1,655

2,066

View full text Add to dashboard Cite

Background: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, Coronavirus Disease 2019 (COVID-19), affecting thousands of people around the world. Urgent guidance for clinicians caring for the sickest of these patients is needed. Methods: We formed a panel of 36 experts from 12 countries. All panel members completed the World Health Organization conflict of interest disclosure form. The panel proposed 53 questions that are relevant to the management of COVID-19 in the ICU. We searched the literature for direct and indirect evidence on the management of COVID-19 in critically ill patients in the ICU. We identified relevant and recent systematic reviews on most questions relating to supportive care. We assessed the certainty in the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, then generated recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility. Recommendations were either strong or weak, or in the form of best practice recommendations. Results: The Surviving Sepsis Campaign COVID-19 panel issued 54 statements, of which four are best practice statements, nine are strong recommendations, and 35 are weak recommendations. No recommendation was provided for six questions. The topics were: 1) infection control, 2) laboratory diagnosis and specimens, 3) hemodynamic support, 4) ventilatory support, and 5) COVID-19 therapy. Conclusion: The Surviving Sepsis Campaign COVID-19 panel issued several recommendations to help support healthcare workers caring for critically ill ICU patients with COVID-19. When available, we will provide new evidence in further releases of these guidelines.

show abstract

“…Ample evidence from critical care medicine, neonatal intensive care, flight medicine, and diving physiology support this assertion. (Abdo, 2012, Allerdet-Servent, 2019, Aubier, 1980, Barlow, 1944, Hanson, 1996, Jing, 2019, Lee, 2018, Merriman, 1955, Ogino, 2016, Robinson, 2000, Westlake, 1958, Yang, 2018 As mentioned earlier, much research has been devoted to identifying contaminants entering the pilot's breathing apparatus. (Denola, 2011) In high performance military aircraft, the pressure required to drive gases into the pilot's breathing mask is typically provided by the aircraft engine.…”

Section: Co2 Narcosis As the Cause Of Upesmentioning

confidence: 99%

Liberal Oxygen with Unreliable Unpredictable Flowrate Is the Root Cause of Unexplained Physiological Events in Combat aircraft

Bassovitch¹

2020

Preprint

View full text Add to dashboard Cite

Over the last 20 years, there has been a significant increase in the number of unexplained physiological events (UPEs) reported by pilots of fighter jets across different fleets. The UPEs have resulted in grounding some types of aircraft, loss of airplanes, and even loss of life. Despite considerable research, no single agreed-upon root cause has been found that explains UPEs, and therefore no reliable corrective actions exist. The purpose of this review was to analyze the literature related to other industries in which artificial hyperoxic gas mixes are employed and similar adverse reports have been reported. Based on analysis of the literature, it is hypothesized that UPEs are caused by unlimited delivery of high-dose oxygen in excess of officially approved oxygen schedules in the presence of inadequate airflow rates, at a time when the positive pressure breathing feature of their oxygen regulator system is not used. During flight maneuvers such as climbs, turns, and descents, pulmonary vital capacity is impaired by G-maneuvers and oxygen- and G-induced atelectasis. At the same time, tidal volume is reduced by flight gear, and effective gas exchange is not supported by adequate ventilation. These factors combine to produce hypercarbia, respiratory acidosis, acute respiratory distress syndrome, CO2 narcosis, and coma. In fact, reports from field data related to incidents in F-18S/H, showing that emergency oxygen did not correct the hypoxia-like symptoms including long-lasting periods of incapacitation and prolonged headaches, lend support to this hypothesis.

show abstract

High flow nasal cannulae oxygen therapy in acute‐moderate hypercapnic respiratory failure

Abstract: There was no difference of the 30-day mortality and intubation rate between HFNC and NIV groups.

Cited by 102 publications

References 39 publications

Comparison of high flow nasal cannula with noninvasive ventilation in chronic obstructive pulmonary disease patients with hypercapnia in preventing postextubation respiratory failure: A pilot randomized controlled trial

Comparison of high flow nasal cannula with noninvasive ventilation in chronic obstructive pulmonary disease patients with hypercapnia in preventing postextubation respiratory failure: A pilot randomized controlled trial

Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)

Liberal Oxygen with Unreliable Unpredictable Flowrate Is the Root Cause of Unexplained Physiological Events in Combat aircraft

Contact Info

Product

Resources

About