A Systematic Review of the High-flow Nasal Cannula for Adult Patients

Helviz, Yigal; Einav, Sharon

doi:10.1186/s13054-018-1990-4

Cited by 130 publications

(111 citation statements)

References 48 publications

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“…HFNC consists of humidified, high flow (up to 60 L/min) oxygen with a maximum FiO 2 of 100%. At high flow rates, HFNC is generally considered to provide 4-6 cm H 2 O of added inspiratory pressure 119. Prospective RCTs in both the ICU and the postoperative period have found that HFNC is non-inferior to NIPPV in terms of preventing respiratory failure but is better tolerated in terms of patients’ comfort 120121.…”

Section: Additional Considerationsmentioning

confidence: 99%

Perioperative lung protective ventilation

O’Gara

Talmor

2018

BMJ

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Perioperative lung injury is a major source of postoperative morbidity, excess healthcare use, and avoidable mortality. Many potential inciting factors can lead to this condition, including intraoperative ventilator induced lung injury. Questions exist as to whether protective ventilation strategies used in the intensive care unit for patients with acute respiratory distress syndrome are equally beneficial for surgical patients, most of whom do not present with any pre-existing lung pathology. Studied both individually and in combination as a package of intraoperative lung protective ventilation, the use of low tidal volumes, moderate positive end expiratory pressure, and recruitment maneuvers have been shown to improve oxygenation and pulmonary physiology and to reduce postoperative pulmonary complications in at risk patient groups. Further work is needed to define the potential contributions of alternative ventilator strategies, limiting excessive intraoperative oxygen supplementation, use of non-invasive techniques in the postoperative period, and personalized mechanical ventilation. Although the weight of evidence strongly suggests a role for lung protective ventilation in moderate risk patient groups, definitive evidence of its benefit for the general surgical population does not exist. However, given the shift in understanding of what is needed for adequate oxygenation and ventilation under anesthesia, the largely historical arguments against the use of intraoperative lung protective ventilation may soon be outdated, on the basis of its expanding track record of safety and efficacy in multiple settings.

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Section: Additional Considerationsmentioning

confidence: 99%

Perioperative lung protective ventilation

O’Gara

Talmor

2018

BMJ

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“…, Hernández et al . , Helviz & Einav ) and (5) decreased ventilatory drive and breathing effort in obstructive disease (Di Mussi et al . ), allowing the use of HOT in hypoxaemic and hypercapnic respiratory failure.…”

Section: Introductionmentioning

confidence: 99%

“…In human medicine, a non-invasive oxygen delivery technique known as high-flow oxygen therapy (HOT) has emerged as an alternative to conventional oxygen therapy (Helviz & Einav 2018). This system allows for delivery of warmed and fully humidified gas with high flow rates of up to 60 L/minute through a specific high-flow nasal cannula, with a FIO 2 ranging from 21 to 100% (Frat et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Prospective pilot study for evaluation of high‐flow oxygen therapy in dyspnoeic dogs: the HOT‐DOG study

Pouzot‐Nevoret

Hocine

Nègre

et al. 2019

J of Small Animal Practice

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Objectives To describe the use, effectiveness and tolerance of high‐flow oxygen therapy in dyspnoeic dogs. Materials and Methods Prospectively, dogs in acute respiratory distress admitted to an intensive care unit between January and May 2018 that failed to respond to nasal oxygen therapy and medical stabilisation after 30 minutes were transitioned to high‐flow oxygen therapy. High‐flow oxygen therapy, delivered an inspired oxygen fraction of 100% using an air/oxygen blender, active humidifier, single warmed tube and specific nasal cannula. Respiratory rate, pulse oximetry (SpO2), heart rate and a tolerance score were assessed every 15 minutes from T0 (under nasal oxygen) to 1 hour (T60), and PaO2 and PaCO2 at T0 and T60. Complications were recorded for each dog. Results Eleven dogs were included. At T60, PaO2, flow rate and SpO2 were significantly greater than at T0 (171 ± 123 versus 73 ± 24 mmHg; P=0.015; 18 ±12 L/minute versus 3.2 ± 2.0 L/minute, P<0.01; 97.7 ±2.3% versus 91.6 ±7.2%, P=0.03, respectively). There was no significant difference in PaCO2, respiratory rate or heart rate between T0 and T60. Tolerance was excellent, and there were no complications. Clinical Significance High‐flow oxygen therapy improves markers of oxygenation in dyspnoeic dogs and is an effective means to deliver oxygen with comfort and minimal complications.

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“…HHFNC has been recommended for spontaneously breathing adults with hypoxemia, or discomfort from increased respiratory effort . It has been used in adults with acute respiratory failure, pneumonia, immunocompromise, during airway procedures, post‐extubation and palliative care . The utility of HHFNC in hypercapnic respiratory failure is still uncertain .…”

Section: What Are the Indications For Hhfnc?mentioning

confidence: 99%

“…5,[8][9][10][11] It has been used in adults with acute respiratory failure, 12 pneumonia, 12 immunocompromise, 13 during airway procedures, 14 post-extubation 15 and palliative care. 3,16 The utility of HHFNC in hypercapnic respiratory failure is still uncertain. 7,17 It is seen as a useful alternative in a patient who does not tolerate NIV.…”

Section: What Are the Indications For Hhfnc?mentioning

confidence: 99%