High-Flow Nasal Cannula Oxygen in Critically Ill Adults: Do the Nose or Lungs Know There's a Difference?

Efficacy of High-Flow Oxygen by Nasal Cannula With Active Humidification in a Patient With Acute Respiratory Failure of Neuromuscular Origin

“…5 In recent years, heated, humidified high-flow nasal cannula (HFNC) has been introduced into medical practice. 6 There is emerging evidence that HFNC may be effective in various clinical settings, including acute respiratory failure, 7-9 after cardiac surgery, 10,11 during sedation and analgesia, 12 in acute heart failure, 13 in hypoxemic respiratory distress, in do-not-intubate patients, 14 and in patients with chronic cough and copious secretions, 15 pulmonary fibrosis, 16 or cancer, 17 in critical care areas 18 and in the emergency department. 19 We report on a patient with ALS with acute hypercapnic respiratory failure who was successfully treated with HFNC.…”

The effects of high-flow nasal cannula on intubation and re-intubation in critically ill patients: a systematic review, meta-analysis and trial sequential analysis

“…An oxygen supply with flows higher than 6L/minute is considered a high-flow therapy; however, under standard care, this supply is generally not heated or humidified and can reach a maximum flow of 15L/min. (1) The use of the a high-flow nasal cannula (HFNC) allows flow rates up to 60L/min because of the use of a heater and humidifier. (2) This heated air provides a relative humidity of 100%, which improves the work of the mucociliary epithelium and provides greater comfort to the patient.…”

“…The following physiological effects of the HFNC should be highlighted: 1) reduction of anatomical dead space; 2) decrease in airway resistance; 3) increase in lung compliance; 4) improvement in bronchial hygiene; and 5) maintenance of a certain level of positive pressure at the end of expiration (approximately 3 - 6cmH 2 O). (1-6) Clinically, these physiological effects translate into decreased respiratory work during breathing and improvement of hypoxemia. (1-6) Additionally, some of its advantages include the comfort reported by the patient compared to conventional oxygen therapy or non-invasive ventilation (NIV) and the decrease in the sensation of dyspnea that can be explained by high inspiratory flow.…”

A Prospective Observational Study Of Nasal High Flow In A Cardiothoracic And Vascular Intensive Care And High Dependency Unit

“…However NHF is significantly more complex and costly than a simple face mask or low flow nasal cannula. It is therefore difficult to justify NHF for patients who are experiencing mild or transient hypoxemia (Wattier & Ward, 2011). Nasal high flow would be unlikely to meet the criteria of being the simplest, most comfortable and cost effective option to meet the patient"s needs.…”

“…In anticipation of an extensive evidence base, NHF appears to be a promising new respiratory support modality (Roca et al, 2010) which provides a useful tool in the armourmentarium of respiratory support therapies currently available (Wattier & Ward, 2011). As we learn more it will become easier to match the most appropriate therapy to the patients needs while balancing the risks, benefits and limitations of each therapy against one another.…”