High-flow nasal cannulae for respiratory support in adult intensive care patients

Corley, Amanda; Rickard, Claire M; Aitken, Leanne M.; Johnston, Amy; Barnett, Adrian; Fraser, John F.; Lewis, Sharon R; Smith, Andrew F

doi:10.1002/14651858.cd010172.pub2

Cited by 57 publications

(12 citation statements)

References 91 publications

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“…It is considered an alternative for patients with severe hypoxemic ARF [ 86 ], although in comparison to conventional oxygen therapy and NIMV, a recent systematic review with a meta-analysis did not show for the HFNC a significant reduction of intubation rate and mortality [ 90 ]. Similary, a Cochrane review [ 91 ], due to very limited data, is unable to demonstrate whether HFNC provides an efficacy respiratory support for adult ICU patients. In addition, some risks of bias among included studies, differences in patient groups, and high levels of statistical heterogeneity for some outcomes, lead to uncertainty results [ 91 ].…”

Section: Oxygen Therapy High Flow Nasal Cannulae (Hfnc) Oxygen Theramentioning

confidence: 99%

“…Similary, a Cochrane review [ 91 ], due to very limited data, is unable to demonstrate whether HFNC provides an efficacy respiratory support for adult ICU patients. In addition, some risks of bias among included studies, differences in patient groups, and high levels of statistical heterogeneity for some outcomes, lead to uncertainty results [ 91 ].…”

Section: Oxygen Therapy High Flow Nasal Cannulae (Hfnc) Oxygen Theramentioning

confidence: 99%

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Management of severe acute exacerbations of COPD: an updated narrative review

Crisafulli

Barbeta

Ielpo

et al. 2018

Multidiscip Respir Med

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BackgroundPatients with chronic obstructive pulmonary disease (COPD) may experience an acute worsening of respiratory symptoms that results in additional therapy; this event is defined as a COPD exacerbation (AECOPD). Hospitalization for AECOPD is accompanied by a rapid decline in health status with a high risk of mortality or other negative outcomes such as need for endotracheal intubation or intensive care unit (ICU) admission. Treatments for AECOPD aim to minimize the negative impact of the current exacerbation and to prevent subsequent events, such as relapse or readmission to hospital.Main bodyIn this narrative review, we update the scientific evidence about the in-hospital pharmacological and non-pharmacological treatments used in the management of a severe AECOPD. We review inhaled bronchodilators, steroids, and antibiotics for the pharmacological approach, and oxygen, high flow nasal cannulae (HFNC) oxygen therapy, non-invasive mechanical ventilation (NIMV) and pulmonary rehabilitation (PR) as non-pharmacological treatments. We also review some studies of non-conventional drugs that have been proposed for severe AECOPD.ConclusionSeveral treatments exist for severe AECOPD patients requiring hospitalization. Some treatments such as steroids and NIMV (in patients admitted with a hypercapnic acute respiratory failure and respiratory acidosis) are supported by strong evidence of their efficacy. HFNC oxygen therapy needs further prospective studies. Although antibiotics are preferred in ICU patients, there is a lack of evidence regarding the preferred drugs and optimal duration of treatment for non-ICU patients. Early rehabilitation, if associated with standard treatment of patients, is recommended due to its feasibility and safety. There are currently few promising new drugs or new applications of existing drugs.

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Section: Oxygen Therapy High Flow Nasal Cannulae (Hfnc) Oxygen Theramentioning

confidence: 99%

Section: Oxygen Therapy High Flow Nasal Cannulae (Hfnc) Oxygen Theramentioning

confidence: 99%

Management of severe acute exacerbations of COPD: an updated narrative review

Crisafulli

Barbeta

Ielpo

et al. 2018

Multidiscip Respir Med

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“…Bei der HFT wird ein erwärmtes und befeuchtetes Luft-Sauerstoff-Gas-Gemisch mit hoher inspiratorischer Flussrate i. d. R. über großlumige Nasenkanülen dem Patienten zugeführt, wobei die Flussrate von bis 60 Liter pro Minute höher ist als bei der konventionellen Sauerstoffgabe 371 . Es sind die folgenden physiologischen Größen einstellbar:…”

Section: Akuttherapieunclassified

S2k-Leitlinie zur fachärztlichen Diagnostik und Therapie von Asthma 2023

et al. 2023

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ZusammenfassungDas Management von Asthma hat sich in den letzten Jahrzehnten fundamental gewandelt. Die vorliegende Leitlinie zur Diagnostik und Therapie von Asthma wurde für pneumologisch tätige Fachärztinnen und Fachärzte entwickelt, welche detaillierte und evidenzbasierte Informationen zu den neuen diagnostischen und therapeutischen Optionen von Asthma benötigen. Die Leitlinie zeigt die neue Bedeutung der Biomarker, insbesondere der Bluteosinophilen und des exhalierten NO (FeNO), in den diagnostischen Algorithmen von Asthma. Als erste Asthma-Leitlinie weltweit benennt die vorliegende Leitlinie die nachhaltige Symptomprävention und die Asthma-Remission als Asthma-Therapieziele, welche durch den Einsatz individuell angepasster, krankheitsmodifizierender Medikamente (wie inhalative Steroide, Allergenimmuntherapie oder Biologika) erreicht werden können. Die zentrale Bedeutung der Behandlung von typischen Asthma-Komorbiditäten wird zudem betont. Schließlich wird auch auf besondere Herausforderungen im Asthma-Management eingegangen, wie bspw. die Therapie von Asthma in der Schwangerschaft, die Behandlung von schwerem Asthma oder die Diagnostik und Therapie von arbeitsbedingten Asthma-Formen.

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“…The clinical efficacy and safety of NHF compared to low-flow oxygen via nasal cannulae or mask, continuous positive airway pressure and bi-level positive airway pressure, in adult COPD patients hospitalized in the ICU, were analysed in the 2017 Cochrane systematic review. Pooled data analysis revealed no differences in carbon dioxide clearance between groups 62…”

Section: Clinical Indications For Copd Patientsmentioning

confidence: 84%

<p>Nasal high flow: physiology, efficacy and safety in the acute care setting, a narrative review</p>

Mauri¹,

Wang²,

Corte³

et al. 2019

OAEM

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Nasal high flow (NHF) is a promising novel oxygen delivery device, whose mechanisms of action offer some beneficial effects over conventional oxygen systems. It is considered to have a number of physiological effects: it improves oxygenation, dynamic lung compliance, homogeneity and end expiratory lung volume; it decreases anatomical dead space and generates a positive airway pressure that can reduce respiratory rate, the work of breathing, and enhance patient comfort. NHF has been used as a prophylactic tool or as a treatment device mostly in patients with acute hypoxemic respiratory failure such as pre-oxygenation before intubation, immunocompromised patients and acute heart failure. Moreover, there is some evidence that NHF could be used during procedural sedation. Finally, NHF was deemed to be effective in chronic obstructive pulmonary disease patients with its positive end expiratory pressure effects and dead-space washout. However, careful monitoring is crucial to maximize NHF settings aimed at maximizing patient comfort while limiting the risk of delayed intubation. The present review presents the most updated evidence for NHF use in the adult acute care setting with the goal of providing clinicians with useful insights on the physiologic effects, main clinical indications, and safety issues of NHF treatment.

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High-flow nasal cannulae for respiratory support in adult intensive care patients

Abstract: Trusted evidence. Informed decisions. Better health.

Cited by 57 publications

References 91 publications

Management of severe acute exacerbations of COPD: an updated narrative review

Management of severe acute exacerbations of COPD: an updated narrative review

S2k-Leitlinie zur fachärztlichen Diagnostik und Therapie von Asthma 2023

<p>Nasal high flow: physiology, efficacy and safety in the acute care setting, a narrative review</p>

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