High flow oxygen cannula: the other side of the moon

Demoule, Alexandre; Rello, Jordi

doi:10.1007/s00134-015-3855-5

Cited by 10 publications

(6 citation statements)

References 15 publications

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“…Maggiore et al showed that HFNC improved oxygenation, comfort, and the reintubation rate in the postextubation setting [8]. Our study also supported the idea that HFNC should be of benefit to some selected patients rather than to all patients [34]. In the present study, different patients had different responses to HFNC: 13 patients showed recruitment without overdistension, 7 patients showed neither recruitment nor overdistension, and 4 patients showed non-recruitment with overdistension.…”

Section: Study Strengths and Limitationssupporting

confidence: 87%

Effect of postextubation high-flow nasal cannula therapy on lung recruitment and overdistension in high-risk patient

Zhang

Long

et al. 2020

Crit Care

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Background: Postextubation high-flow nasal cannula (HFNC) is used as a support therapy in high-risk patients in ICU. This study aimed to determine the effects of HFNC therapy on lung recruitment and overdistension assessed by electrical impedance tomography (EIT). Methods: Twenty-four patients who received HFNC within 24 h after extubation were prospectively enrolled in this study. EIT was used to monitor regional lung ventilation distributions at baseline (conventional oxygen therapy) and three flow rate levels of HFNC therapy (20, 40, and 60 L/min). Change of end-expiratory lung impedance (ΔEELI), regional recruitment (recruited-pixels) and overdistension (overdistended-pixels), and lung strain change were determined by EIT. EIT images were equally divided into four ventral-to-dorsal horizontal regions of interest (ROIs 1, 2, 3, and 4). "Overdistensionby HFNC " due to HFNC is defined as an increase of overdistened-pixels > 10 than baseline. Patients were divided into two groups: (1) high potential of recruitment (HPR), recruited-pixels > 10 pixels at 60 L/min than baseline, and (2) low potential of recruitment (LPR), recruited-pixels < 10 pixels at 60 L/min than baseline. Results: When the flow rate gradually increased from baseline to 60 L/min, a significant and consistent increasing trend of global ΔEELI (%) (p < 0.0001), recruited-pixels (p < 0.001), and overdistended-pixels (p = 0.101) was observed. Moreover, the increase of ΔEELI was mainly distributed in ROI2 (p = 0.001) and ROI3 (p < 0.0001). The HPR group (13/24 patients) had significantly higher recruited-pixels than the LPR group (11/24 patients) at 20, 40, and 60 L/min. There were no significant differences in PaO 2 /FiO 2 , ΔEELI (%), and overdistention pixels between the two groups. The HPR group had 13 patients in which no one had "overdistensionby HFNC ", and the LPR group had 11 patients in which 4 patients had "overdistensionby HFNC " (0/13 vs. 4/11, p = 0.017). Conclusions: Using EIT could identify diverse effects of HFNC on lung regional ventilation in postextubation situations. Further study is required to validate using "HFNC effect" based on lung recruitment and overdistension by EIT in clinical practice. Trial registration: The study was retrospectively registered at www.clinicaltrials.gov (no. NCT04245241).

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Section: Study Strengths and Limitationssupporting

confidence: 87%

Effect of postextubation high-flow nasal cannula therapy on lung recruitment and overdistension in high-risk patient

Zhang

Long

et al. 2020

Crit Care

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“…Second, because this is a cohort study, we were not able to eliminate the effect of unmeasured confounders when each factor was evaluated for its association with cardiac arrest. In particular, effect of delayed intubation in patients under NIV (23) or HFNC (24)(25)(26) was not assessed and could be a major risk factor for cardiac arrest during intubation procedure. Third, some data were missing in the oldest datasets and could not be found retrospectively.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Arrest and Mortality Related to Intubation Procedure in Critically Ill Adult Patients: A Multicenter Cohort Study

Jong

Rolle

Molinari

et al. 2018

Critical Care Medicine

177

145

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“…8 Furthermore, the influence of high airway resistance on PEEP level was not investigated in our study, since the benefit of HFNC in severe air-flow obstruction has not been well established. 21…”

Section: Discussionmentioning

confidence: 99%