Performance of six types of oxygen delivery devices at varying respiratory rates*

Wagstaff, T. A. J.; Soni, Neil

doi:10.1111/j.1365-2044.2007.05026.x

Cited by 142 publications

(96 citation statements)

References 19 publications

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“…Starting flow was 40 L/min, with gas temperature 37°C and F IO 2 of .28 (approximating to 2 L/min via standard nasal prongs 13 ). All nurses, emergency specialists, and residents were trained in the use of HFNC and the study procedures before inception of the study and at regular periods throughout the course of the study.…”

Section: Methodsmentioning

confidence: 99%

Randomized Controlled Trial of Humidified High-Flow Nasal Oxygen for Acute Respiratory Distress in the Emergency Department: The HOT-ER Study

Jones¹,

Kamona²,

Doran³

et al. 2015

Respir Care

138

117

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BACKGROUND: Humidified high-flow nasal cannula (HFNC) is a novel method of oxygen delivery with increasing use in emergency departments and intensive care settings despite little evidence showing benefit over standard oxygen delivery methods (standard O 2 ). The aim of this study was to determine whether HFNC compared with standard O 2 given to subjects in acute respiratory distress would reduce the need for noninvasive ventilation or invasive ventilation. METHODS: This was a pragmatic open randomized controlled trial in adult subjects with hypoxia and tachypnea presenting to a tertiary academic hospital emergency department. The primary outcome was the need for mechanical ventilation in the emergency department. RESULTS: We screened 1,287 patients, 322 met entry criteria and 19 were excluded from analysis. Of these, 165 randomized to HFNC and 138 to standard O 2 were analyzed. Baseline characteristics were similar. In the HFNC group, 3.6% (95% CI 1.5-7.9%) versus 7.2% (95% CI 3.8 -13%) in the standard O 2 group required mechanical ventilation in the emergency department (P ‫؍‬ .16), and 5.5% (95% CI 2.8 -10.2%) in HFNC versus 11.6% (95% CI 7.2-18.1%) in the standard O 2 group required mechanical ventilation within 24 h of admission (P ‫؍‬ .053). There was no difference in mortality or stay. Adverse effects were infrequent; however, fewer subjects in the HFNC group had a fall in Glasgow coma score due to CO 2 retention, 0% (95% CI 0 -3%) versus 2.2% (95% CI 0.4 -6%). One in 12 subjects did not tolerate HFNC. CONCLUSIONS: HFNC was not shown to reduce the need for mechanical ventilation in the emergency department for subjects with acute respiratory distress compared with standard O 2 , although it was safe and may reduce the need for escalation of oxygen therapy within the first 24 h of admission.

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Section: Methodsmentioning

confidence: 99%

Randomized Controlled Trial of Humidified High-Flow Nasal Oxygen for Acute Respiratory Distress in the Emergency Department: The HOT-ER Study

Jones¹,

Kamona²,

Doran³

et al. 2015

Respir Care

138

117

View full text Add to dashboard Cite

show abstract

“…The patient's peak inspiratory flow may vary between 30 and 120 L/min during respiratory failure. 2,3 An alternative to conventional oxygen therapy has been developed. High-flow nasal cannula (HFNC) is a technique that can deliver heated and humidified gas (up to 100% oxygen) at a maximum flow of 60 L/min via nasal prongs or cannula.…”

Section: Introductionmentioning

confidence: 99%

“…Oxygen is usually delivered through a high-F IO 2 , non-rebreathing face mask. [1][2][3] One limitation with conventional oxygen administration is the substantial mismatch between oxygen flow and the patient's inspiratory flow. The patient's peak inspiratory flow may vary between 30 and 120 L/min during respiratory failure.…”

Section: Introductionmentioning

confidence: 99%

Physiologic Effects of High-Flow Nasal Cannula Oxygen in Critical Care Subjects

et al. 2015

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INTRODUCTION: High-flow nasal cannula (HFNC) can deliver heated and humidified gas (up to 100% oxygen) at a maximum flow of 60 L/min via nasal prongs or cannula. The aim of this study was to assess the short-term physiologic effects of HFNC. Inspiratory muscle effort, gas exchange, dyspnea score, and comfort were evaluated. METHODS: Twelve subjects admitted to the ICU for acute hypoxemic respiratory failure were prospectively included.

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“…When the patient's respiratory effort and respiratory rate change in devices delivering oxygen at low flow rates, the oxygen delivery to the patient also changes. When the flow rate is adjusted according to the patient's breathing effort and the severity of respiratory failure, the FiO 2 given in HFNO is less affected by the change in the patient's inspiratory effort (20,21). The FiO 2 that is measured, especially at the high flow rates in HFNO, is closer to the delivered FiO 2 , and this is more evident when the mouth is closed.…”

Section: C Oxygen Presentationmentioning

confidence: 77%

High Flow Nasal Oxygen Therapy: From Physiology to Clinic

Yıldırım¹,

Öcal²,

Ersoy³

et al. 2017

Eurasian J Pulmonol

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INTRODUCTIONOxygen support therapy should be given to the patients with acute hypoxic respiratory insufficiency in order to provide oxygenation of the tissues until the underlying pathology improves. The inspiratory flow rate requirement of patients with respiratory insufficiency varies between 30 and 120 L/min. Low flow and high flow conventional oxygen support systems produce a maximum flow rate of 15 L/min, and FiO 2 changes depending on the patient's peak inspiratory flow rate, respiratory pattern, the mask that is used, or the characteristics of the cannula. The inability to provide adequate airflow leads to discomfort in tachypneic patients. With high-flow nasal oxygen (HFNO) cannulas, warmed and humidified air matching the body temperature can be regulated at flow rates of 5-60 L/min, and oxygen delivery varies between 21% and 100%. When HFNO, first used in infants, was reported to increase the risk of infection, its long-term use was stopped. This problem was later eliminated with the use of sterile water, and its use has become a current issue in critical adult patients as well. Studies show that HFNO treatment improves physiological parameters when compared to conventional oxygen systems. Although there are studies indicating successful applications in different patient groups, there are also studies indicating that it does not create any difference in clinical parameters, but patient comfort is better in HFNO when compared with standard oxygen therapy and noninvasive mechanical ventilation (NIMV) (1-6). In this compilation, the physiological effect mechanisms of HFNO treatment and its use in various clinical situations are discussed in the light of current studies. The Impact Mechanisms of High Flow Nasal Oxygen TherapyThe HFNO device consists of an air/oxygen mixer, an active heater, a humidifier, a unidirectional inspiratory circuit hose, and a soft nasal cannula that is slightly larger than the standard nasal cannula. AbstractHigh-flow nasal oxygen (HFNO) therapy has several physiological advantages over traditional oxygen therapy devices, including decreased nasopharyngeal resistance, washing out of the nasopharyngeal dead space, generation of positive pressure in the pharynx, increasing alveolar recruitment in the lungs, humidification of the airways, increased fraction of inspired oxygen and improved mucociliary clearance. Recently, the use of HFNO in treating adult critical illness patients has significantly increased, and it is now being used in many patients with a range of different disease conditions. However, there are no established guidelines to direct the safe and effective use of HFNO for critical patients. This review summarizes the positive physiological effects, mechanisms of action, and the clinical applications of HFNO with available published literatures.

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Performance of six types of oxygen delivery devices at varying respiratory rates*

Cited by 142 publications

References 19 publications

Randomized Controlled Trial of Humidified High-Flow Nasal Oxygen for Acute Respiratory Distress in the Emergency Department: The HOT-ER Study

Randomized Controlled Trial of Humidified High-Flow Nasal Oxygen for Acute Respiratory Distress in the Emergency Department: The HOT-ER Study

Physiologic Effects of High-Flow Nasal Cannula Oxygen in Critical Care Subjects

High Flow Nasal Oxygen Therapy: From Physiology to Clinic

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