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Emily Eaton Turner, Michelle Jenks
OBJECTIVE: To estimate the cost-effectiveness of Nasal High Flow (NHF) in the intensive care unit (ICU) compared with standard oxygen or non-invasive ventilation (NIV) from a UK NHS perspective. METHODS: Three cost-effectiveness models were developed to reflect scenarios of NHF use: first-line therapy (pre-intubation model); post-extubation in low-risk, and high-risk patients. All models used randomized control trial data on the incidence of intubation/re-intubation, events leading to intubation/re-intubation, mortality and complications...
December 5, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
Kenric Tam, Caroline Jeffery, C Kwang Sung
OBJECTIVE: Airway management during endoscopic surgical treatment of supraglottic and pharyngeal stenosis is often challenging and can be accomplished by various means, including tracheostomy, jet ventilation, or direct laryngoscopy. We describe CO2 laser excision of supraglottic-pharyngeal stenosis using intubationless Optiflow high-flow nasal cannula (HFNC). METHODS: A 55-year-old male presented with dyspnea and dysphagia secondary to severe supraglottic-pharyngeal stenosis in the setting of previous chemoradiation for a T0N2aM0 squamous cell carcinoma...
September 2017: Annals of Otology, Rhinology, and Laryngology
Jonathan Dugernier, Michel Hesse, Thibaud Jumetz, Emilie Bialais, Jean Roeseler, Virginie Depoortere, Jean-Bernard Michotte, Xavier Wittebole, Stephan Ehrmann, Pierre-François Laterre, François Jamar, Gregory Reychler
BACKGROUND: High-flow nasal cannula use is developing in ICUs. The aim of this study was to compare aerosol efficiency by using two nebulizers through a high-flow nasal cannula: the most commonly used jet nebulizer (JN) and a more efficient vibrating-mesh nebulizer (VN). METHODS: Aerosol delivery of diethylenetriaminepentaacetic acid labeled with technetium-99m (4 mCi/4 mL) to the lungs by using a VN (Aerogen Solo®; Aerogen Ltd., Galway, Ireland) and a constant-output JN (Opti-Mist Plus Nebulizer®; ConvaTec, Bridgewater, NJ) through a high-flow nasal cannula (Optiflow®; Fisher & Paykel, New Zealand) was compared in six healthy subjects...
October 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
Susan Humphreys, Derek Rosen, Tessa Housden, Julia Taylor, Andreas Schibler
BACKGROUND: Transnasal Humidified Rapid-Insufflation Ventilatory Exchange has been shown to safely prolong the safe apnea time in well children post induction of anesthesia and is rapidly becoming a new standard for apneic oxygenation in adults. The same oxygenation technique is described as nasal high flow and can be used in infants and children at risk of apnea during anesthesia. AIM: We investigated the use of nasal high flow oxygen delivery during anesthesia in children with abnormal airways requiring tubeless airway assessment or surgery...
June 2017: Paediatric Anaesthesia
Marc Glickman
The need to have consistent methods and consistent technique to optimize hemodialysis outcomes is behind the concept of the Optiflow™ device. This device was created to allow for consistency in size of the arterial anastomosis and consistency in angle of the vein to the artery at the anastomosis. Early data suggest that allowing these two technical entities can improve outcomes in regards to flow and maturity in arteriovenous fistula creation. This article is a summary of early data that demonstrate the impact the Optiflow device on brachial cephalic fistulas...
March 6, 2017: Journal of Vascular Access
K S Ang, A Green, K K Ramaswamy, C Frerk
No abstract text is available yet for this article.
March 1, 2017: British Journal of Anaesthesia
A Pillai, V Daga, J Lewis, M Mahmoud, M Mushambi, D Bogod
Ten healthy volunteers received oxygen for 1 min, 2 min and 3 min at 10 l.min(-1) via a face mask, or humidified oxygen at 60 l.min(-1) via nasal prongs (Optiflow(TM) ) with the mouth closed and with the mouth open. The mean (SD) end-tidal oxygen partial pressure after 3 min face mask and Optiflow oxygenation, with mouth closed and open, were: 88.5 (6.2) kPa; 85.6 (6.4) kPa and 48.7 (26.4) kPa, respectively, p = 0.001. The equivalent mean (SD) transcutaneous oxygen partial pressures were: 34.6 (5...
November 2016: Anaesthesia
Bilal M Ansari, Maurice P Hogan, Tim J Collier, Robert A Baddeley, Marco Scarci, Aman S Coonar, Fiona E Bottrill, Guillermo C Martinez, Andrew A Klein
BACKGROUND: Patients undergoing thoracic surgery are at risk of postoperative pulmonary complications, which are associated with increased morbidity and mortality. High-flow nasal oxygen therapy delivers humidified, warmed positive airway pressure but has not been tested routinely after thoracic surgery. METHODS: We performed a randomized, controlled, blinded study. Patients undergoing elective lung resection were randomly assigned to either high-flow nasal oxygen or standard oxygen therapy...
February 2016: Annals of Thoracic Surgery
Calum T Roberts, Rebecca Kortekaas, Jennifer A Dawson, Brett J Manley, Louise S Owen, Peter G Davis
OBJECTIVE: Heating and humidification of inspired gases is routine during neonatal non-invasive respiratory support. However, little is known about the temperature and humidity delivered to the upper airway. The International Standards Organization (ISO) specifies that for all patients with an artificial airway humidifiers should deliver ≥33 g/m(3) absolute humidity (AH). We assessed the oropharyngeal temperature and humidity during different non-invasive support modes in a neonatal manikin study...
May 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Rachael L Parke, Andreas Bloch, Shay P McGuinness
BACKGROUND: Previous research has demonstrated a positive linear correlation between flow delivered and airway pressure generated by high-flow nasal therapy. Current practice is to use flows over a range of 30-60 L/min; however, it is technically possible to apply higher flows. In this study, airway pressure measurements and electrical impedance tomography were used to assess the relationship between flows of up to 100 L/min and changes in lung physiology. METHODS: Fifteen healthy volunteers were enrolled into this study...
October 2015: Respiratory Care
Kristina A Gaunt, Sarah K Spilman, Meghan E Halub, Julie A Jackson, Keith D Lamb, Sheryl M Sahr
BACKGROUND: Humidified, high-flow nasal cannula (HFNC) enables mucociliary clearance, accurate oxygen measurement, precise control of flow, and low-level positive airway pressure. There is sparse information concerning the timing of HFNC on patient outcomes such as incidence of adverse events during hospitalization, ICU stay, and post-ICU stay. METHODS: This is a retrospective analysis of a heterogeneous population of medical and trauma ICU patients who received HFNC therapy in a critical care setting...
October 2015: Respiratory Care
Milind Nikam, Eric Solomon Chemla, Jackie Evans, Angela Summers, Paul Brenchley, Afshin Tavakoli, Prabir Roy-Chaudhury, Sandip Mitra
OBJECTIVE: Arteriovenous fistula (AVF) maturation failure remains a significant problem with reported early failure rates around 50%. Suboptimal hemodynamics, variable surgical skills, and technique dependency are widely believed to contribute to AVF nonmaturation. The Optiflow (Bioconnect Systems, Ambler, Pa) is a novel anastomotic device placed in situ that has potential for improving hemodynamics and standardizing AVF placement. We report results from a prospective nonrandomized controlled pilot study designed to investigate the safety and performance of the Optiflow...
April 2015: Journal of Vascular Surgery
Fatemah S Sunbul, James B Fink, Robert Harwood, Meryl M Sheard, Ralph D Zimmerman, Arzu Ari
UNLABELLED: Aerosol drug delivery via high flow nasal cannula (HFNC), bubble continuous positive airway pressure (CPAP), and synchronized inspiratory positive airway pressure (SiPAP) has not been quantified in spontaneously breathing premature infants. OBJECTIVES: The purpose of this study was to compare aerosol delivery via HFNC, bubble CPAP, and SiPAP in a model of a simulated spontaneously breathing preterm infant. WORKING HYPOTHESIS: The types of CPAP systems and nebulizer positions used during aerosol therapy will impact aerosol deposition in simulated spontaneously breathing infants...
November 2015: Pediatric Pulmonology
Yusuke Chikata, Masayo Izawa, Nao Okuda, Taiga Itagaki, Emiko Nakataki, Mutsuo Onodera, Hideaki Imanaka, Masaji Nishimura
INTRODUCTION: Delivering heated and humidified medical gas at 20-60 L/min, high-flow nasal cannula (HFNC) creates low levels of PEEP and ameliorates respiratory mechanics. It has become a common therapy for patients with respiratory failure. However, independent measurement of heat and humidity during HFNC and comparison of HFNC devices are lacking. METHODS: We evaluated 2 HFNC (Airvo 2 and Optiflow system) devices. Each HFNC was connected to simulated external nares using the manufacturer's standard circuit...
August 2014: Respiratory Care
Emmanuel Futier, Catherine Paugam-Burtz, Jean-Michel Constantin, Bruno Pereira, Samir Jaber
BACKGROUND: Respiratory support following postoperative extubation is of major importance to prevent hypoxemia and subsequent respiratory failure and reintubation. High-flow nasal cannula oxygen (HFNC) delivers a flow-dependent positive airway pressure and improves oxygenation by increasing end-expiratory lung volume. Whether application of HFNC may have therapeutic advantages over conventional oxygen therapy for respiratory support in the early postextubation surgical period remains to be established...
October 18, 2013: Trials
Eric Chemla, Afshin Tavakoli, Milind Nikam, Sandip Mitra, Tlou Malete, Jackie Evans, Prabir Roy-Chaudhury
PURPOSE: Arteriovenous fistulas (AVFs) are the preferred form of vascular access for hemodialysis. However, non-maturation and patency are major clinical problems. The Optiflow™ device is an implantable anastomotic connector used to standardize the creation of an AVF. Studies have suggested that the geometry of the anastomosis and experience of the surgeon impact patency and maturation rates. The Optiflow serves as a surgical template whereby the geometry and flow path of the anastomosis are predetermined...
January 2014: Journal of Vascular Access
Takeshi Yano, Masumi Nagahama, Tetsu Yonaha, Ryuji Tamura, Miyako Yano, Hiroshi Matsuoka, Mitsuo Oshikawa, Masahiko Taniguchi, Isao Tsuneyoshi
A 63-year-old female with obesity (body mass index of 32.0 kg x m(-2)) was scheduled for total abdominal hysterectomy under combined epidural general anesthesia. The surgical procedure was completed without any troubles. Immediately after tracheal extubation, however, the patient developed acute respiratory distress, and the percutaneous oxygen saturation (Spo2) decreased from 97 to 44% for 1 minute. When the patient was admitted to our intensive care unit due to hypoxia, arterial blood gas values showed pH 7...
August 2013: Masui. the Japanese Journal of Anesthesiology
G Chanques, F Riboulet, N Molinari, J Carr, B Jung, A Prades, F Galia, E Futier, J M Constantin, S Jaber
AIM: High-flow-oxygen-therapy is provided by various techniques and patient interfaces, resulting in various inspired-fraction of oxygen (FiO2) and airway-pressure levels. However, tracheal measurements have never been performed. METHODS: Three oxygen-delivery-devices were evaluated: 1) standard-high-flow-oxygen-facemask with reservoir-bag, 2) Optiflow(TM)-high-flow-nasal-cannulae and 3) Boussignac(TM)-oxygen-therapy-system. Main judgment criteria were airway-pressure and FiO2 measured in the trachea...
December 2013: Minerva Anestesiologica
Oriol Roca, Purificación Pérez-Terán, Joan R Masclans, Lourdes Pérez, Enrique Galve, Arturo Evangelista, Jordi Rello
PURPOSE: High flow nasal cannula (HFNC) may decrease preload being associated with beneficial hemodynamic and respiratory effects in adults with heart failure. METHODS: This is a sequential intervention prospective study including 10 adults with New York Heart Association (NYHA) class III and left ventricle ejection fraction 45% or less. High flow gas was administered (fraction of inspired oxygen, 0.21) through nasal cannula (Optiflow(TM); Fisher & Paykel, Auckland, New Zealand)...
October 2013: Journal of Critical Care
Jordi Rello, Marcos Pérez, Oriol Roca, Garyphallia Poulakou, Jéssica Souto, César Laborda, Joan Balcells, Joaquim Serra, Joan Ramon Masclans
PURPOSE: The experience with high-flow nasal cannula (HFNC) oxygen therapy in severe acute respiratory infection (SARI) is limited. The objective was to assess the effectiveness of HFNC oxygen therapy in adult patients with SARI by confirmed 2009 influenza A/H1N1v infection (by real-time reverse transcription polymerase chain reaction testing). MATERIAL AND METHODS: A single-center post hoc analysis of a cohort of intensive care unit patients admitted with SARI due to 2009 Influenza A/H1N1v was done...
October 2012: Journal of Critical Care
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