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High flow nasal oxygen adults

Elie Azoulay, Virginie Lemiale, Djamel Mokart, Saad Nseir, Laurent Argaud, Frédéric Pène, Loay Kontar, Fabrice Bruneel, Kada Klouche, François Barbier, Jean Reignier, Anabelle Stoclin, Guillaume Louis, Jean-Michel Constantin, Julien Mayaux, Florent Wallet, Achille Kouatchet, Vincent Peigne, Pierre Perez, Christophe Girault, Samir Jaber, Johanna Oziel, Martine Nyunga, Nicolas Terzi, Lila Bouadma, Christine Lebert, Alexandre Lautrette, Naike Bigé, Jean-Herlé Raphalen, Laurent Papazian, Antoine Rabbat, Michael Darmon, Sylvie Chevret, Alexandre Demoule
BACKGROUND: Acute respiratory failure (ARF) is the leading reason for intensive care unit (ICU) admission in immunocompromised patients. High-flow nasal oxygen (HFNO) therapy is an alternative to standard oxygen. By providing warmed and humidified gas, HFNO allows the delivery of higher flow rates via nasal cannula devices, with FiO2 values of nearly 100%. Benefits include alleviation of dyspnea and discomfort, decreased respiratory distress and decreased mortality in unselected patients with acute hypoxemic respiratory failure...
March 5, 2018: Trials
Francesco Montecchia, Fabio Midulla, Paola Papoff
Measuring work of breathing (WOB) is an intricate task during high-flow nasal cannula (HFNC) therapy because the continuous unidirectional flow toward the patient makes pneumotachography technically difficult to use. We implemented a new method for measuring WOB based on a differential pneumotachography (DP) system, equipped with one pneumotachograph inserted in the HFNC circuit and another connected to a monitoring facemask, combined with a leak correction algorithm (LCA) that corrects flow measurement errors arising from leakage around the monitoring facemask...
February 24, 2018: Medical Engineering & Physics
Deog Kyeom Kim, Jungsil Lee, Ju Hee Park, Kwang Ha Yoo
Acute exacerbation(s) of chronic obstructive pulmonary disease (AECOPD) tend to be critical and debilitating events leading to poorer outcomes in relation to chronic obstructive pulmonary disease (COPD) treatment modalities, and contribute to a higher and earlier mortality rate in COPD patients. Besides pro-active preventative measures intended to obviate acquisition of AECOPD, early recovery from severe AECOPD is an important issue in determining the long-term prognosis of patients diagnosed with COPD. Updated GOLD guidelines and recently published American Thoracic Society/European Respiratory Society clinical recommendations emphasize the importance of use of pharmacologic treatment including bronchodilators, systemic steroids and/or antibiotics...
January 24, 2018: Tuberculosis and Respiratory Diseases
Luca Cabrini, Giovanni Landoni, Martina Baiardo Radaelli, Omar Saleh, Carmine D Votta, Evgeny Fominskiy, Alessandro Putzu, Cézar Daniel Snak de Souza, Massimo Antonelli, Rinaldo Bellomo, Paolo Pelosi, Alberto Zangrillo
BACKGROUND: We performed a systematic review of randomized controlled studies evaluating any drug, technique or device aimed at improving the success rate or safety of tracheal intubation in the critically ill. METHODS: We searched PubMed, BioMed Central, Embase and the Cochrane Central Register of Clinical Trials and references of retrieved articles. Finally, pertinent reviews were also scanned to detect further studies until May 2017. The following inclusion criteria were considered: tracheal intubation in adult critically ill patients; randomized controlled trial; study performed in Intensive Care Unit, Emergency Department or ordinary ward; and work published in the last 20 years...
January 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
Kazuma Nagata, Takashi Kikuchi, Takeo Horie, Akira Shiraki, Takamasa Kitajima, Toru Kadowaki, Fumiaki Tokioka, Naohiko Chohnabayashi, Akira Watanabe, Susumu Sato, Keisuke Tomii
RATIONALE: A growing evidence base suggests a benefit of using high-flow nasal cannula oxygen therapy (HFNC) in the acute setting. However, the clinical benefit of domiciliary use of HFNC in patients with chronic hypercapnic respiratory failure due to chronic obstructive pulmonary disease (COPD) remains unclear. OBJECTIVES: To evaluate the efficacy and safety of HFNC use in stable COPD patients. METHODS: This was a multicenter, randomized crossover trial comparing HFNC plus long-term oxygen therapy (HFNC/LTOT) with LTOT-only in 32 adults with stable hypercapnic COPD...
December 28, 2017: Annals of the American Thoracic Society
Charles P Moore, Ira M Katz, Georges Caillibotte, Warren H Finlay, Andrew R Martin
BACKGROUND: Primary benefits of high flow nasal cannula therapy include washout of carbon dioxide rich exhaled gas and increased airway pressures during tidal breathing. This work reports on the influence of high flow nasal cannula outlet area on upper airways gas clearance and tracheal pressures using measurements in five realistic adult nose-throat airway replicas. METHODS: Two commercial high flow nasal cannulas and one generic nasal cannula of varying size were compared...
November 11, 2017: Clinical Biomechanics
N Douglas, I Ng, F Nazeem, K Lee, P Mezzavia, R Krieser, D Steinfort, L Irving, R Segal
Traditional conscious sedation for endobronchial ultrasound procedures places patients at risk of desaturation, and high-flow nasal oxygen may reduce the risk. We designed a parallel-group randomised controlled trial of high-flow nasal oxygen at a flow rate of 30-70 l.min-1 via nasal cannulae, compared with standard oxygen therapy at 10 l.min-1 via a bite block in adults planned for conscious sedation for endobronchial ultrasound. The primary outcome was the proportion of patients experiencing desaturation (defined as SpO2 < 90%)...
February 2018: Anaesthesia
Yue-Nan Ni, Jian Luo, He Yu, Dan Liu, Bin-Miao Liang, Rong Yao, Zong-An Liang
BACKGROUND: The effects of high flow nasal cannula (HFNC) on adult patients after extubation remain controversial. We aimed to further determine the effectiveness of HFNC in comparison to noninvasive positive pressure ventilation (NIPPV) and conventional oxygen therapy (COT). METHODS: The Pubmed, Embase, Medline, Cochrane Central Register of Controlled Trails (CENTRAL) as well as the Information Sciences Institute (ISI) Web of Science were searched for all the controlled study comparing HFNC with NIPPV and COT in adult patients after extubation...
November 17, 2017: BMC Pulmonary Medicine
Matthew G Drake
High-flow nasal cannula oxygenation has distinct advantages over other oxygen devices because of its unique effects on respiratory physiology. In particular, adjustable oxygen delivery and flow-dependent carbon dioxide clearance reduce work of breathing and better match inspiratory demand during respiratory distress. Historically, few studies had evaluated whether the physiologic effects of these devices translated into clinical benefit. However, recent publications have begun to address this knowledge gap...
February 2018: Annals of the American Thoracic Society
Janine Pilcher, Michael Richards, Leonie Eastlake, Steven J McKinstry, George Bardsley, Sarah Jefferies, Irene Braithwaite, Mark Weatherall, Richard Beasley
OBJECTIVE: To compare the effects on transcutaneous carbon dioxide tension (Ptco2) of high concentration and titrated oxygen therapy in medical inpatients with morbid obesity who were not selected for a pre-existing diagnosis of obesity hypoventilation syndrome. DESIGN: A randomised, crossover trial undertaken between February and September 2015. SETTING: Internal medicine service, Wellington Regional Hospital, New Zealand. PARTICIPANTS: 22 adult inpatients, aged 16 years or more, with a body mass index exceeding 40 kg/m<sup>2</sup>...
November 20, 2017: Medical Journal of Australia
Phillip Kwan-Giet Lee, Anton Willis Gerard Booth, Kim Vidhani
High-flow nasal oxygen (HFNO) is a potentially life-saving adjunct in the emergency management of the obstructed airway. HFNO has multiple beneficial applications in critical care and respiratory support, but its use in emergency-obstructed airway management has not been defined. This case report describes spontaneous respiration using intravenous anesthesia and high-flow nasal oxygen to successfully manage acute adult epiglottitis with rapidly progressing airway obstruction. Oxygenation, carbon dioxide levels, and airway patency were maintained, which facilitated endotracheal intubation while the patient was spontaneously breathing during general anesthesia...
September 26, 2017: A & A Case Reports
Mathieu Delorme, Pierre-Alexandre Bouchard, Mathieu Simon, Serge Simard, François Lellouche
OBJECTIVES: High-flow nasal cannula is increasingly used in the management of respiratory failure. However, little is known about its impact on respiratory effort, which could explain part of the benefits in terms of comfort and efficiency. This study was designed to assess the effects of high-flow nasal cannula on indexes of respiratory effort (i.e., esophageal pressure variations, esophageal pressure-time product/min, and work of breathing/min) in adults. DESIGN: A randomized controlled crossover study was conducted in 12 patients with moderate respiratory distress (i...
December 2017: Critical Care Medicine
Yue-Nan Ni, Jian Luo, He Yu, Dan Liu, Bin-Miao Liang, Zong-An Liang
BACKGROUND: The effects of high flow nasal cannula (HFNC) on adult patients when used before mechanical ventilation (MV) are unclear. We aimed to determine the effectiveness of HFNC when used before MV by comparison to conventional oxygen therapy (COT) and noninvasive positive pressure ventilation (NIPPV). METHODS: The Pubmed, Embase, Medline, Cochrane Central Register of Controlled Trials (CENTRAL) as well as the Information Sciences Institute (ISI) Web of Science were searched for all the controlled studies that compared HFNC with NIPPV and COT when used before MV in adult patients...
July 28, 2017: American Journal of Emergency Medicine
Huiying Zhao, Huixia Wang, Feng Sun, Shan Lyu, Youzhong An
BACKGROUND: High-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. METHODS: A review of the literature was conducted from the electronic databases from inception up to 20 October 2016...
July 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
Alison M Pirret, Susan F Takerei, Claire L Matheson, Meghan Kelly, Wharewaina Strickland, Joanne Harford, Nicola E Jepsen, Lisa J Welsh, Chloe P A Allan
BACKGROUND: Whilst research demonstrates the benefits of nasal high flow oxygen in the intensive care setting, limited literature exists on its benefits in ward patients. OBJECTIVES: This study evaluated the use of nasal high flow oxygen in adult ward patients with respiratory failure or at risk of respiratory deterioration. Primary outcome was an improvement in pulmonary function as indicated by decreases in respiratory and heart rates and an increase in arterial oxygen saturation via pulse oximetry...
October 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Patricia A Dailey, Robert Harwood, Kyle Walsh, James B Fink, Tina Thayer, Greg Gagnon, Arzu Ari
BACKGROUND: Heliox (helium-oxygen mixture) has been shown to reduce turbulence and improve aerosol delivery in a range of clinical settings. We questioned whether heliox as compared with oxygen via high-flow nasal cannula (HFNC) would affect aerosol delivery. We hypothesized that heliox would have a significant effect on aerosol delivery as compared with oxygen with both quiet and distressed breathing patterns. METHODS: A vibrating mesh nebulizer was placed at the inlet of a humidifier via HFNC with small adult cannula distal to the heated-wire circuit with prongs placed into simulated nares with a T-shaped trap and absolute filter connected to a breath simulator set to adult quiet and distressed breathing parameters...
September 2017: Respiratory Care
Amanda Corley, Claire M Rickard, Leanne M Aitken, Amy Johnston, Adrian Barnett, John F Fraser, Sharon R Lewis, Andrew F Smith
BACKGROUND: High-flow nasal cannulae (HFNC) deliver high flows of blended humidified air and oxygen via wide-bore nasal cannulae and may be useful in providing respiratory support for adult patients experiencing acute respiratory failure in the intensive care unit (ICU). OBJECTIVES: We evaluated studies that included participants 16 years of age and older who were admitted to the ICU and required treatment with HFNC. We assessed the safety and efficacy of HFNC compared with comparator interventions in terms of treatment failure, mortality, adverse events, duration of respiratory support, hospital and ICU length of stay, respiratory effects, patient-reported outcomes, and costs of treatment...
May 30, 2017: Cochrane Database of Systematic Reviews
Florent Baudin, Alexandra Buisson, Blandine Vanel, Bruno Massenavette, Robin Pouyau, Etienne Javouhey
BACKGROUND: Asthma is the most common obstructive airway disease in children and adults. Nasal high flow (NHF) is a recent device that is now used as a primary support for respiratory distress. Several studies have reported use of NHF as a respiratory support in status asthmaticus; however, there are no data to recommend such practice. We therefore conducted this preliminary study to evaluate NHF therapy for children with status asthmaticus admitted to our PICU in order to prepare a multicentre randomized controlled study...
December 2017: Annals of Intensive Care
Jennifer L Daly, Christine L Guenther, Jamie M Haggerty, Iain Keir
OBJECTIVE To evaluate the safety and efficacy of oxygen administration by use of a high-flow nasal cannula (HFNC) in sedated clinically normal dogs. ANIMALS 6 healthy adult dogs undergoing routine dental prophylaxis. PROCEDURES Dogs were sedated with butorphanol tartrate and dexmedetomidine. An esophageal balloon catheter was inserted into the esophagus, a double-pronged nasal cannula was inserted into the nares, and a catheter was inserted into the dorsal pedal artery. Dogs were positioned in right lateral recumbency...
May 2017: American Journal of Veterinary Research
Hua-Wei Huang, Xiu-Mei Sun, Zhong-Hua Shi, Guang-Qiang Chen, Lu Chen, Jan O Friedrich, Jian-Xin Zhou
PURPOSE: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of high-flow nasal cannula (HFNC) on reintubation in adult patients. PROCEDURES: Ovid Medline, Embase, and Cochrane Database of Systematic Reviews were searched up to November 1, 2016, for RCTs comparing HFNC versus conventional oxygen therapy (COT) or noninvasive ventilation (NIV) in adult patients after extubation. The primary outcome was reintubation rate, and the secondary outcomes included complications, tolerance and comfort, time to reintubation, length of stay, and mortality...
January 1, 2017: Journal of Intensive Care Medicine
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