Use of high-flow nasal canulae: effect on alveolar pressure and its limitation

Hayami, H; Mizutani, Kenji; Shioda, M.; Takaki, Satoshi; Maejima, H; Ueno, Kana; Yamaguchi, Yoshiko; Kariya, Takayuki; Gotoh, Takashi

doi:10.1186/cc12029

Cited by 4 publications

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“…HFNC has several advantages when compared to conventional oxygen therapy (COT): (1) the high-flow rates match the patient’s inspiratory flow rates, which creates a positive pressure effect [ 5 , 6 ] and reduces the anatomic dead space [ 7 ]; (2) HFNC can deliver a predictable and constant FiO 2 [ 8 ]; (3) HFNC can increase the partial arterial pressure of oxygen (PaO 2 )/FIO 2 ratio, which reduces the entrainment of room air and the dilution of oxygen [ 1 , 2 ]; (4) the heated and humidified gas that is inhaled can improve mucociliary motion and sputum clearance [ 3 , 9 ]; and (5) there is reduced upper airway resistance, reduced work of breathing [ 10 ] and improvement in thoraco-abdominal synchrony [ 11 , 12 ]. Based on the above advantages, several studies found that HFNC could improve comfort level [ 13 – 15 ], increase oxygenation [ 12 , 14 – 17 ] and decrease the dyspnoea score in adult patients [ 3 , 12 , 14 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

High-flow nasal cannula oxygen therapy is superior to conventional oxygen therapy but not to noninvasive mechanical ventilation on intubation rate: a systematic review and meta-analysis

et al. 2017

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BackgroundHigh-flow nasal cannula oxygen (HFNC) is a relatively new therapy used in adults with respiratory failure. Whether it is superior to conventional oxygen therapy (COT) or to noninvasive mechanical ventilation (NIV) remains unclear. The aim of the present study was to investigate whether HFNC was superior to either COT or NIV in adult acute respiratory failure patients.MethodsA review of the literature was conducted from the electronic databases from inception up to 20 October 2016. Only randomized clinical trials comparing HFNC with COT or HFNC with NIV were included. The intubation rate was the primary outcome; secondary outcomes included the mechanical ventilation rate, the rate of escalation of respiratory support and mortality.ResultsEleven studies that enrolled 3459 patients (HFNC, n = 1681) were included. There were eight studies comparing HFNC with COT, two comparing HFNC with NIV, and one comparing all three. HFNC was associated with a significant reduction in intubation rate (OR 0.52, 95% CI 0.34 to 0.79, P = 0.002), mechanical ventilation rate (OR 0.56, 95% CI 0.33 to 0.97, P = 0.04) and the rate of escalation of respiratory support (OR 0.45, 95% CI 0.31 to 0.67, P < 0.0001) when compared to COT. There was no difference in mortality between HFNC and COT utilization (OR 1.01, 95% CI 0.67 to 1.53, P = 0.96). When HFNC was compared to NIV, there was no difference in the intubation rate (OR 0.96; 95% CI 0.66 to 1.39, P = 0.84), the rate of escalation of respiratory support (OR 1.00, 95% CI 0.77 to 1.28, P = 0.97) or mortality (OR 0.85, 95% CI 0.43 to 1.68, P = 0.65).ConclusionsCompared to COT, HFNC reduced the rate of intubation, mechanical ventilation and the escalation of respiratory support. When compared to NIV, HFNC showed no better outcomes. Large-scale randomized controlled trials are necessary to prove our findings.Trial registrationPROSPERO International prospective register of systematic reviews on May 25, 2016 registration no. CRD42016039581.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-017-1760-8) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

High-flow nasal cannula oxygen therapy is superior to conventional oxygen therapy but not to noninvasive mechanical ventilation on intubation rate: a systematic review and meta-analysis

et al. 2017

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Ultrasound Assessment of Respiratory Workload With High-Flow Nasal Oxygen Versus Other Noninvasive Methods After Chest Surgery

Laverdure

Genty

Rézaiguia-Delclaux

et al. 2019

Journal of Cardiothoracic and Vascular Anesthesia

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Respiratory Support During Pulmonary Artery Thromboembolia (Review)

Остапченко

Гутников

Рубанова

et al. 2020

Obŝaâ reanimatologiâ

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Pulmonary artery thromboembolia (PATE) is not a clinical entity as such, but a complication of diﬀerent diseases and conditions leading to deep thrombosis in the low tension circulation system, right cardiac chambers or causing local thrombosis in the pulmonary artery system. PATE is characterized by complex pathogenesis of respiratory failure of varying severity, which makes it diﬃcult to choose a respiratory support technique.Purpose of the overview: to show advantages of diﬀerent respiratory support techniques and prospects of high-ﬂux oxygen therapy with regard to PATE pathophysiology.82 sources were selected based on the principle of combining clinical and experimental data from papers published over the recent 5 years and earlier that are still relevant for medical practice.The overview presents the structure of main causes and prevalence of PATE and considers thrombogenesis stages and predominant manifestations of respiratory failure during PATE occurring due to inconsistency between pulmonary ventilation and perfusion. Review discusses ﬁve methods of respiratory therapy in PATE patients: low-ﬂux and high-ﬂux oxygen therapy, non-invasive and invasive artiﬁcial lung ventilation, extracorporeal blood oxygenation. Finally, the paper shows the eﬃcacy and limitations of these methods.Conclusion. High-ﬂux oxygen therapy seems to be the most eﬀective and promising technique in PATE patients thanks to absence of adverse cardiohemodynamic consequences, subjective comfort for patients, and relation to minimal risks of secondary infectious complications.Nevertheless, the clinical experience accumulated is insuﬃcient to make an absolute choice of one particular technique for respiratory support during PATE. It is necessary to continue investigating the clinical eﬃcacy of high-ﬂux oxygen therapy in the speciﬁc population of patients who experienced PATE.

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Use of high-flow nasal canulae: effect on alveolar pressure and its limitation

Cited by 4 publications

References 0 publications

High-flow nasal cannula oxygen therapy is superior to conventional oxygen therapy but not to noninvasive mechanical ventilation on intubation rate: a systematic review and meta-analysis

High-flow nasal cannula oxygen therapy is superior to conventional oxygen therapy but not to noninvasive mechanical ventilation on intubation rate: a systematic review and meta-analysis

Ultrasound Assessment of Respiratory Workload With High-Flow Nasal Oxygen Versus Other Noninvasive Methods After Chest Surgery

Respiratory Support During Pulmonary Artery Thromboembolia (Review)

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