High flow nasal cannula: an alternative to continuous positive airway pressure in cats

Baudin, Florent; Pouzot‐Nevoret, Céline; Hocine, Leila; Allaouchiche, Bernard

doi:10.1177/1098612x20977779

Cited by 4 publications

(6 citation statements)

References 11 publications

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“…Based on the human literature, HFNOT presents theoretical benefits in the provision of oxygen support in acute exacerbations of feline asthma. However, reports of the use of HFNOT in cats are too scarce to evaluate its feasibility ( 147 ).…”

Section: Discussionmentioning

confidence: 99%

“…A single Letter to the Editor briefly reports the successful clinical use of HFNOT in cats ( 147 ). The authors report the need for sedation to enable the appropriate placement and securing of the nasal cannula but that treatment has been otherwise well tolerated and may be considered as an alternate treatment to CPAP generated by helmet ( 12 ).…”

Section: High-flow Nasal Oxygen Therapy In Veterinary Patientsmentioning

confidence: 99%

“…Many studies have reported the use of sedation to facilitate initiation and/or maintenance of HFNOT in veterinary patients, although this is not required in all patients ( 25 , 26 , 28 , 30 , 147 ). Sedation protocols should be based on individual patient factors and assessment, however, the use of butorphanol and/or α 2 -agonists is often reported ( 150 , 151 ).…”

Section: Clinical Application Of High Flow Nasal Oxygen Therapymentioning

confidence: 99%

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Clinical review of high-flow nasal oxygen therapy in human and veterinary patients

Whitney¹,

Keir²

2023

Front. Vet. Sci.

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Oxygen therapy is the first-line treatment for hypoxemic acute respiratory failure. In veterinary medicine this has traditionally been provided via mask, low-flow nasal oxygen cannulas, oxygen cages and invasive positive pressure ventilation. Traditional non-invasive modalities are limited by the maximum flow rate and fraction of inspired oxygen (FiO2) that can be delivered, variability in oxygen delivery and patient compliance. The invasive techniques are able to provide higher FiO2 in a more predictable manner but are limited by sedation/anesthesia requirements, potential complications and cost. High-flow nasal oxygen therapy (HFNOT) represents an alternative to conventional oxygen therapy. This modality delivers heated and humidified medical gas at adjustable flow rates, up to 60 L/min, and FiO2, up to 100%, via nasal cannulas. It has been proposed that HFNOT improves pulmonary mechanics and reduces respiratory fatigue via reduction of anatomical dead space, provision of low-level positive end-expiratory pressure (PEEP), provision of constant FiO2 at rates corresponding to patient requirements and through improved patient tolerance. Investigations into the use of HFNOT in veterinary patients have increased in frequency since its clinical use was first reported in dogs with acute respiratory failure in 2016. Current indications in dogs include acute respiratory failure associated with pulmonary parenchymal disease, upper airway obstruction and carbon monoxide intoxication. The use of HFNOT has also been advocated in certain conditions in cats and foals. HFNOT is also being used with increasing frequency in the treatment of a widening range of conditions in humans. Although there remains conflict regarding its use and efficacy in some patient groups, overall these reports indicate that HFNOT decreases breathing frequency and work of breathing and reduces the need for escalation of respiratory support. In addition, they provide insight into potential future veterinary applications. Complications of HFNOT have been rarely reported in humans and animals. These are usually self-limiting and typically result in lower morbidity and mortality than those associated with invasive ventilation techniques.

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Section: Discussionmentioning

confidence: 99%

Section: High-flow Nasal Oxygen Therapy In Veterinary Patientsmentioning

confidence: 99%

Section: Clinical Application Of High Flow Nasal Oxygen Therapymentioning

confidence: 99%

See 1 more Smart Citation

Clinical review of high-flow nasal oxygen therapy in human and veterinary patients

Whitney¹,

Keir²

2023

Front. Vet. Sci.

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“…After an extensive review of the available literature, only one letter to the editor has mentioned the use of HFOT in a cat. 13 In the present report, we describe a case of successful use of HFOT in a cat that failed to respond to conventional oxygen therapy.…”

Section: Introductionmentioning

confidence: 88%

Use of high-flow oxygen therapy in a cat with cardiogenic pulmonary edema

Pouzot-Nevoret,

Hocine,

Allaouchiche

et al. 2023

Journal of Feline Medicine and Surgery Open Reports

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Case summary A 7-month-old female spayed domestic shorthair cat was presented for respiratory distress due to cardiogenic pulmonary edema. Despite initial treatment and oxygen delivery in an oxygen tent, the cat still showed signs of severe respiratory effort and oxygen saturation measured via pulse oximetry was below 85%. Because the owners declined mechanical ventilation, the cat was transitioned to high-flow oxygen therapy (HFOT). HFOT allowed significant improvement of the respiration parameters within 15 mins without causing clinical complications. The cat was briefly anaesthetised for the placement of the nasal cannula on initiation of HFOT, and the interface was well tolerated thereafter. The cat was transitioned to an oxygen cage after 16 h, weaned from oxygen 4 h later and was discharged after 3 days of hospitalisation. Long-term follow-up showed no abnormalities, and the leading hypothesis was transient myocardial thickening. Relevance and novel information The first use of HFOT in a dyspneic cat is described in this study. HFOT could be a life-saving option for cats with severe hypoxemia or do-not-intubate orders that fail to respond to conventional oxygen therapies.

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“…5 –8 Despite the substantial amount of literature on HFNOT in dogs, the utility of HFNOT in feline patients is not as well-documented. The current literature primarily consists of two case reports, with Baudin et al 9 being the first to report its application in a cat. The initial placement of the nasal cannula in the report required sedation; however, subsequent heavy sedation was not required thereafter.…”

Section: Introductionmentioning

confidence: 99%

High-flow nasal cannula oxygen therapy in seven cats with respiratory failure

Her,

Verwaerde,

Baker

et al. 2024

Journal of Feline Medicine and Surgery

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Case series summary This case series describes seven cats that were treated with high-flow nasal cannula oxygen therapy (HFNOT). Seven cats were prospectively (n = 5) or retrospectively (n = 2) included from three veterinary university referral centers between March 2020 and September 2023. Data on signalment, medical history, clinical and diagnostic findings, treatment administered, response to HFNOT and outcomes were recorded. All cats included in this case series failed to respond to oxygen cage or flow-by oxygen therapy and were subsequently transitioned to HFNOT. After this transition, these cats demonstrated a marked improvement in respiratory parameters, including respiratory rate, effort and oxygen saturation measured by pulse oximetry, within 1 h of initiating HFNOT. All cats tolerated HFNOT well without any complications. Relevance and novel information There is limited literature reporting the use of HFNOT in feline patients. This is the first case series in the literature of HFNOT utilized as an advanced oxygen delivery method for feline respiratory failure. This case series indicates that HFNOT improves oxygenation in feline patients that fail to respond to conventional oxygen therapy.

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High flow nasal cannula: an alternative to continuous positive airway pressure in cats

Cited by 4 publications

References 11 publications

Clinical review of high-flow nasal oxygen therapy in human and veterinary patients

Clinical review of high-flow nasal oxygen therapy in human and veterinary patients

Use of high-flow oxygen therapy in a cat with cardiogenic pulmonary edema

High-flow nasal cannula oxygen therapy in seven cats with respiratory failure

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