High-Flow Nasal Oxygen Therapy in Acute Hypoxemic Respiratory Failure: Concise Review on Technology and Initial Methodology

Abstract

High-flow nasal cannula oxygen therapy (HFNCOT) system consists of an air/oxygen supply system capable of delivering up to 100% humidified and heated oxygen at a flow rate of up to 80 L/min. The system includes a blender, active humidifier, single heated tube, and nasal cannula. HFNCOT has many physiological advantages compared with other standard oxygen therapies, such as anatomical dead space washout, more constant fraction of inspired oxygen, positive end-expiratory (PEEP) effect, supplement of adequate humidification and maintenance of muco-ciliary function. HFNCOT is mostly used for hypoxemic acute respiratory failure, although it also has other indications. HFNCOT is a common choice of physicians as its technology makes it more silent and comfortable. Though HFNCOT is used in many clinical settings, there is a lack of publications addressing devices and initial settings. We present a review on HFNCOT, with focus on device and application methodology.

Flow Effects of High-flow Nasal Oxygenation: Comment

“…2 Thus, the air being expired from the lung will be opposed by the fresh gas flow from the high-flow nasal cannula, which will produce a positive end-expiratory pressure–like effect, changing the lung volume and influencing ventilation. 2,3 With paralysis, the resistance against the expiratory flow will be lost.…”

Oxygen therapy alternatives in COVID-19: From classical to nanomedicine

“…The HFNC common components include a flow generator capable of delivering varied rates of oxygen (up to 60 L/min), an air mixer capable of boosting (from 21% to 100%), fraction of inspired oxygen (FiO 2 ) and an air humidifier and heater (from 31 °C to 37 °C) [ 23 , 35 ]. More information about the equipment and the application methodology can be found at [ 36 ]. Owing to the high flow rate, HFNC reduces airway resistance and increases the ventilation oxygenation potential of the lung tissue [ 37 ].…”

Methodological Insight to the High-Flow Nasal Cannula Oxygenation in Elderly Undergoing Endoscopic Retrograde Cholangiopancreatography

“…Continuous positive airway pressure (CPAP) like effects of HFNC is vital to have the maximal benefit of it [ 2 , 3 ]. the authors accept that using HFNC with an open mouth can limit some of the beneficial effects of CPAP or positive end-expiratory pressure, which helps prevent a decrease in lung capacity.…”