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Emmanuel Futier, Catherine Paugam-Burtz, Thomas Godet, Linda Khoy-Ear, Sacha Rozencwajg, Jean-Marc Delay, Daniel Verzilli, Jeremie Dupuis, Gerald Chanques, Jean-Etienne Bazin, Jean-Michel Constantin, Bruno Pereira, Samir Jaber
PURPOSE: High-flow nasal cannula (HFNC) oxygen therapy is attracting increasing interest in acute medicine as an alternative to standard oxygen therapy; however, its use to prevent hypoxaemia after major abdominal surgery has not been evaluated. Our trial was designed to close this evidence gap. METHODS: A multicentre randomised controlled trial was carried out at three university hospitals in France. Adult patients at moderate to high risk of postoperative pulmonary complications who had undergone major abdominal surgery using lung-protective ventilation were randomly assigned using a computer-generated sequence to receive either HFNC oxygen therapy or standard oxygen therapy (low-flow oxygen delivered via nasal prongs or facemask) directly after extubation...
October 22, 2016: Intensive Care Medicine
Samir Jaber, Marion Monnin, Mehdi Girard, Matthieu Conseil, Moussa Cisse, Julie Carr, Martin Mahul, Jean Marc Delay, Fouad Belafia, Gérald Chanques, Nicolas Molinari, Audrey De Jong
PURPOSE: High-flow nasal cannula oxygen (HFNC) has the potential to provide apnoeic oxygenation. We decided to assess in a proof-of-concept study whether the addition of HFNC to non-invasive ventilation (NIV) could reduce oxygen desaturation during intubation, compared with NIV alone for preoxygenation, in severely hypoxaemic intensive care unit (ICU) patients with respiratory failure. METHODS: We conducted a randomised, controlled, single-centre trial with assessor-blinded outcome assessment in patients admitted to the ICU...
October 11, 2016: Intensive Care Medicine
Jian Zhang, Ling Lin, Konghan Pan, Jiancang Zhou, Xiaoyin Huang
High-flow nasal cannula (HFNC) oxygen therapy has several physiological advantages over traditional oxygen therapy devices, including decreased nasopharyngeal resistance, washing out of the nasopharyngeal dead space, generation of positive pressure in the pharynx, increasing alveolar recruitment in the lungs, humidification of the airways, increased fraction of inspired oxygen and improved mucociliary clearance. Recently, the use of HFNC in treating adult critical illness patients has significantly increased, and it is now being used in many patients with a range of different disease conditions...
October 2, 2016: Journal of International Medical Research
Serena Cirio, Manuela Piran, Michele Vitacca, Giancarlo Piaggi, Piero Ceriana, Matteo Prazzoli, Mara Paneroni, Annalisa Carlucci
INTRODUCTION: High flow nasal cannula (HFNC) was shown to washout the anatomical dead space, permitting a higher fraction of minute ventilation to participate in gas pulmonary exchanges. Moreover, it is able to guarantee the desired inhaled oxygen fraction (FiO2) even at high level of patient's minute ventilation by minimizing the room air entrainment. The effect of HFNC has never been investigated on stable severe COPD patients in term of endurance capacity with standardised laboratory tests...
September 2016: Respiratory Medicine
Samir Jaber, Nicolas Molinari, Audrey De Jong
INTRODUCTION: Tracheal intubation in the intensive care unit (ICU) is associated with severe life-threatening complications including severe hypoxaemia. Preoxygenation before intubation has been recommended in order to decrease such complications. Non-invasive ventilation (NIV)-assisted preoxygenation allows increased oxygen saturation during the intubation procedure, by applying a positive end-expiratory pressure (PEEP) to prevent alveolar derecruitment. However, the NIV mask has to be taken off after preoxygenation to allow the passage of the tube through the mouth...
August 12, 2016: BMJ Open
Florent Baudin, Sebastien Gagnon, Benjamin Crulli, François Proulx, Philippe Jouvet, Guillaume Emeriaud
BACKGROUND: High-flow nasal cannula (HFNC) therapy is increasingly used in pediatric ICUs as an intermediate level of support between conventional oxygen delivery and noninvasive ventilation (NIV). The safety of HFNC has seldom been studied, and some cases of barotrauma have been reported. This retrospective study aims to describe HFNC use in a tertiary care pediatric ICU, with a focus on the complications associated with this therapy. METHODS: Between January 2013 and January 2014, all children <18 y old treated with HFNC in the pediatric ICU were included...
October 2016: Respiratory Care
Suma B Hoffman, Natalie Terrell, Colleen Hughes Driscoll, Natalie L Davis
BACKGROUND: Heated humidified high-flow nasal cannula (HFNC) is thought to be comparable with nasal CPAP. The effect of multimodality mid-level respiratory support use in the neonatal ICU is unknown. The objective of this work was to evaluate the effect of introducing HFNC on length of respiratory support and stay. METHODS: A chart review was conducted on subjects at 24-32 weeks gestation requiring mid-level support (HFNC/nasal CPAP) 1 y before and after HFNC implementation...
October 2016: Respiratory Care
Ingvild Bruun Mikalsen, Peter Davis, Knut Øymar
High flow nasal cannula (HFNC) is a relatively new non-invasive ventilation therapy that seems to be well tolerated in children. Recently a marked increase in the use of HFNC has been seen both in paediatric and adult care settings. The aim of this study was to review the current knowledge of HFNC regarding mechanisms of action, safety, clinical effects and tolerance in children beyond the newborn period.We performed a systematic search of the databases PubMed, Medline, EMBASE and Cochrane up to 12th of May 2016...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
J R Azevedo, W S Montenegro, A L Leitao, M M Silva, J S Prazeres, J P Maranhao
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Marcel Simon, Christian Wachs, Stephan Braune, Geraldine de Heer, Daniel Frings, Stefan Kluge
BACKGROUND: Critically ill patients with respiratory failure undergoing intubation have an increased risk of hypoxemia-related complications. Delivering oxygen via a high-flow nasal cannula (HFNC) has theoretical advantages and is increasingly used. This study was conducted to compare HFNC with bag-valve-mask (BVM) for preoxygenation and to assess oxygenation during intubation in subjects with hypoxemic respiratory failure. METHODS: This study was a randomized controlled trial including 40 critically ill subjects with hypoxemic respiratory failure who received either HFNC or BVM for preoxygenation before intubation in the ICU...
September 2016: Respiratory Care
Rémi Coudroy, Angéline Jamet, Philippe Petua, René Robert, Jean-Pierre Frat, Arnaud W Thille
BACKGROUND: Acute respiratory failure is the main cause of admission to intensive care unit in immunocompromised patients. In this subset of patients, the beneficial effects of noninvasive ventilation (NIV) as compared to standard oxygen remain debated. High-flow nasal cannula oxygen therapy (HFNC) is an alternative to standard oxygen or NIV, and its use in hypoxemic patients has been growing. Therefore, we aimed to compare outcomes of immunocompromised patients treated using HFNC alone or NIV as a first-line therapy for acute respiratory failure in an observational cohort study over an 8-year period...
December 2016: Annals of Intensive Care
Kaito Harada, Shuhei Kurosawa, Yutaro Hino, Keita Yamamoto, Masahiro Sakaguchi, Shuntaro Ikegawa, Keiichro Hattori, Aiko Igarashi, Kyoko Watakabe, Yasushi Senoo, Yuho Najima, Takeshi Hagino, Noriko Doki, Takeshi Kobayashi, Kazuhiko Kakihana, Toshihiro Iino, Hisashi Sakamaki, Kazuteru Ohashi
A high-flow nasal cannula (HFNC) is a newly developed device that enables high-flow oxygen therapy for patients with serious cardiopulmonary problems, but there are few data regarding its use in patients with hematological disease. The efficacy and tolerability of HFNCs for patients who developed ARF during the treatment of various hematological diseases was evaluated. Fifty-six patients underwent HFNC therapy during the last 2 years, and the causes of ARF were mainly pneumonia (n = 37) or acute congestive heart failure (n = 7)...
2016: SpringerPlus
Paula Heikkilä, Leena Forma, Matti Korppi
We evaluated the cost-effectiveness of high-flow nasal cannula (HFNC) to provide additional oxygen for infants with bronchiolitis, compared to standard low-flow therapy. The cost-effectiveness was evaluated by decision analyses, using decision tree modeling, and was based on real costs from our recently published retrospective case-control study. The data on the effectiveness of HFNC treatment were collected from earlier published retrospective studies, using admission rates to pediatric intensive care units (PICU)...
May 5, 2016: Pediatric Pulmonology
Yufeng Luo, Rong Ou, Yun Ling, Tiehe Qin
OBJECTIVE: To investigate the value of high flow nasal cannula (HFNC) in treating a patient with Middle East respiratory syndrome (MERS). METHODS: The effect of HFNC applied in the first imported MERS patient with complication of acute respiratory distress syndrome (ARDS) to China was observed. The patient was admitted to Department of Critical Care Medicine of Huizhou Municipal Central Hospital on May 28th, 2015, and the changes in various clinical parameters and their significance were analyzed...
October 2015: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Oriol Roca, Gonzalo Hernández, Salvador Díaz-Lobato, José M Carratalá, Rosa M Gutiérrez, Joan R Masclans
High flow nasal cannula (HFNC) supportive therapy has emerged as a safe, useful therapy in patients with respiratory failure, improving oxygenation and comfort. Recently several clinical trials have analyzed the effectiveness of HFNC therapy in different clinical situations and have reported promising results. Here we review the current knowledge about HFNC therapy, from its mechanisms of action to its effects on outcomes in different clinical situations.
April 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
Sarah L Morley
Non-invasive ventilation (NIV) is a well recognised and increasingly prevalent intervention in the paediatric critical care setting. In the acute setting NIV is used to provide respiratory support in a flexible manner that avoids a requirement for endotracheal intubation or tracheostomy, with the aim of avoiding the complications of invasive ventilation. This article will explore the physiological benefits, complications and epidemiology of the different modes of NIV including continuous positive airway pressure (CPAP), non-invasive positive pressure ventilation (NIPPV) and high-flow nasal cannula oxygen (HFNC)...
March 14, 2016: Paediatric Respiratory Reviews
Gregorio P Milani, Anna M Plebani, Elisa Arturi, Danila Brusa, Susanna Esposito, Laura Dell'Era, Emanuela A Laicini, Dario Consonni, Carlo Agostoni, Emilio F Fossali
AIM: An observational study was carried out on infants with moderate to severe bronchiolitis to compare the clinical outcomes following treatment with a high-flow nasal cannula (HFNC) or standard low-flow oxygen. METHODS: We enrolled subjects below 12 months of age who were affected by their first bronchiolitis episode. Non-formal randomisation, based on HFNC availability, was used to assign subjects to either the HFNC or standard oxygen groups. Respiratory rate, respiratory effort and the ability to feed were compared between the two groups at enrolment and at regular time points...
August 2016: Acta Paediatrica
Lorena Bermúdez Barrezueta, Nuria García Carbonell, Jorge López Montes, Rafael Gómez Zafra, Purificación Marín Reina, Jana Herrmannova, Javier Casero Soriano
OBJECTIVE: To determine whether the availability of heated humidified high-flow nasal cannula (HFNC) therapy was associated with a decrease in need for mechanical ventilation in neonates hospitalised with acute bronchiolitis. METHODS: A combined retrospective and prospective (ambispective) cohort study was performed in a type II-B Neonatal Unit, including hospitalised neonates with acute bronchiolitis after the introduction of HFNC (HFNC-period; October 2011-April 2015)...
April 8, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Andreas Schibler, Donna Franklin
Respiratory support in paediatric emergency settings ranges from oxygen delivery with subnasal oxygen to invasive mechanical ventilation. Recent data suggest that oxygen can cause reperfusion injuries and should be delivered with caution within well-defined clinical target ranges. Most mild to moderate respiratory distress conditions with an oxygen requirement may benefit from early use of continuous positive airway pressure. High-flow nasal cannula therapy (HFNC) is an emerging alternative way to support the inspiratory effort combined with oxygen delivery and positive expiratory pressures without the need of complicated equipment or good compliance from the child...
February 2016: Journal of Paediatrics and Child Health
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