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humidified heated high flow oxygen

Yusuke Chikata, Saki Ohnishi, Masaji Nishimura
BACKGROUND: High-flow nasal cannula therapy (HFNC) for neonate/infants can deliver up to 10 L/min of heated and humidified gas, and FIO2 can be adjusted to between 0.21 and 1.0. With adults, humidification and actual FIO2 are known to vary according to inspiratory and HFNC gas flow, tidal volume (VT), and ambient temperature. There have been few studies focused on humidification and FIO2 in HFNC settings for neonates/infants, so we performed a bench study to investigate the influence of gas flow, ambient temperature, and respiratory parameters on humidification and actual FIO2 in a neonate/infant simulation...
February 7, 2017: Respiratory Care
Sasivimon Soonsawad, Buranee Swatesutipun, Anchalee Limrungsikul, Pracha Nuntnarumit
OBJECTIVES: To compare extubation failure rate between the heated humidified high-flow nasal cannula (HHHFNC) and continuous positive airway pressure (CPAP) groups. METHODS: Intubated infants with gestational age (GA) <32 wk, who were ready to extubate, were randomized to receive respiratory support with either CPAP or HHHFNC after extubation. In CPAP group, nasal mask CPAP with preset pressure and fraction of inspired oxygen (FiO2) equal to positive end-expiratory pressure (PEEP) and FiO2 of ventilator before extubation was applied...
January 5, 2017: Indian Journal of Pediatrics
Michael A Boyle, Arunava Dhar, Rajiv Chaudhary, Susan Kent, S Samantha O'Hare, Theodore Dassios, Susan Broster
No abstract text is available yet for this article.
December 15, 2016: Acta Paediatrica
Yusuke Chikata, Mutsuo Onodera, Jun Oto, Masaji Nishimura
BACKGROUND: High-flow nasal cannula therapy (HFNC) is widely used for patients with acute respiratory failure. HFNC has a number of physiological effects. Although FIO2 is considered to be constant, because HFNC is an open system, FIO2 varies according to inspiratory flow, tidal volume (VT), and HFNC gas flow. We investigated the influence of HFNC gas flow and other respiratory parameters on FIO2 during HFNC. METHODS: We evaluated an HFNC system and, for comparison, a conventional oxygen therapy system...
February 2017: Respiratory Care
Veronica Mardegan, Elena Priante, Elisabetta Lolli, Paola Lago, Eugenio Baraldi
Heated, humidified high-flow delivered by nasal cannulae (HHHFNC) is increasingly used for noninvasive respiratory support in preterm infants and critically ill children due to its perceived effectiveness and ease of use. Evidence from randomized controlled trials suggests that HHHFNC and continuous positive airway pressure (CPAP) are equally effective as postextubation support in preterm infants. HHHFNC is also used for weaning preterm infants from CPAP. Data on HHHFNC used as the primary support for treating respiratory distress syndrome are conflicting...
September 2016: American Journal of Perinatology
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
Anna Lavizzari, Mariarosa Colnaghi, Francesca Ciuffini, Chiara Veneroni, Stefano Musumeci, Ivan Cortinovis, Fabio Mosca
Importance: Heated, humidified high-flow nasal cannula (HHHFNC) has gained increasing popularity as respiratory support for newborn infants thanks to ease of use and improved patient comfort. However, its role as primary therapy for respiratory distress syndrome (RDS) of prematurity needs to be further elucidated by large, randomized clinical trials. Objective: To determine whether HHHFNC provides respiratory support noninferior to nasal continuous positive airway pressure (nCPAP) or bilevel nCPAP (BiPAP) as a primary approach to RDS in infants older than 28 weeks' gestational age (GA)...
August 8, 2016: JAMA Pediatrics
James Hughes, Ammara Doolabh
OBJECTIVE: The aim of this study was to determine the role that heated, humidified high-flow nasal oxygen (HHHFNO) plays in the adult ED with particular focus on the indications and outcomes of use. METHODS: An explorative study was undertaken using retrospective chart review to identify characteristics of adult patients who received HHHFNO in a tertiary adult ED between January and December 2014. RESULTS: Thirty-nine patients were identified as having received HHHFNO during the study period with a range of indications for this use...
November 2016: Australasian Emergency Nursing Journal: AENJ
Sasivimon Soonsawad, Numtip Tongsawang, Pracha Nuntnarumit
BACKGROUND: Heated humidified high-flow nasal cannula (HHHFNC) therapy has been widely used in preterm infants. However, evidence to support its use as a continuous positive airway pressure (CPAP) weaning method is still controversial. OBJECTIVES: We aimed to compare time to wean directly off CPAP vs. weaning by using HHHFNC. METHODS: Infants with a gestational age (GA) of <32 weeks who met the predefined criteria for weaning off CPAP, i...
2016: Neonatology
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
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)...
January 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Masaji Nishimura
High-flow nasal cannula (HFNC) oxygen therapy is carried out using an air/oxygen blender, active humidifier, single heated tube, and nasal cannula. Able to deliver adequately heated and humidified medical gas at flows up to 60 L/min, it is considered to have a number of physiological advantages compared with other standard oxygen therapies, including reduced anatomical dead space, PEEP, constant F(IO2), and good humidification. Although few large randomized clinical trials have been performed, HFNC has been gaining attention as an alternative respiratory support for critically ill patients...
April 2016: Respiratory Care
Catherine Smith, Jérôme Plojoux, Lise Lucker, Frédéric Lador, Jean-Paul Janssens
During the past year, among the many novelties in the field of pulmonary medicine, the authors chose to focus on 4 items: the positive contribution of systemic steroids on clinical improvement and length of stay in patients hospitalized for community-acquired pneumonia; the interesting results obtained with high flow oxygen, heated and humidified, in acute care and in normocapnic respiratory failure, a device which warrants further clinical testing in other indications; the now documented benefits of lung volume reduction procedures by bronchoscopy using coils in severe emphysema with hyperinflation; and the publication of new recommendations regarding pulmonary hypertension, with an emphasis on new molecules and their efficacy, on an early use of combination treatments, and on the importance of expert centres in managing these patients...
January 13, 2016: Revue Médicale Suisse
Sandeep Shetty, Katie Hunt, Amy Douthwaite, Maria Athanasiou, Ann Hickey, Anne Greenough
OBJECTIVE: To determine whether the time to achieve full oral feeding differed between infants with bronchopulmonary dysplasia (BPD) supported by nasal continuous positive airway pressure (nCPAP) compared with those supported by nCPAP and subsequently transferred to heated, humidified, high-flow nasal cannula oxygen (HHFNC). DESIGN: Two-cohort comparison. SETTING: Tertiary neonatal unit. PATIENTS: -72 infants, median gestational age 27 (range 24-32) weeks in the nCPAP group, and 44 infants, median gestational age 27 (range 24-31) weeks in the nCPAP/HHFNC group...
September 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Yukihiro Horio, Takahisa Takihara, Kyoko Niimi, Masamichi Komatsu, Masako Sato, Jun Tanaka, Hiroto Takiguchi, Hiromi Tomomatsu, Katsuyoshi Tomomatsu, Naoki Hayama, Tsuyoshi Oguma, Takuya Aoki, Tetsuya Urano, Atsushi Takagi, Koichiro Asano
We report 3 cases (all men, age: 69-81 years) of acute exacerbation of interstitial pneumonia (AEIP) that were successfully treated with a high-flow nasal cannula (HFNC), which delivers heated, humidified gas at a fraction of inspired oxygen (FIO2) up to 1.0 (100%). Oxygenation was insufficient under non-rebreathing face masks; however, the introduction of HFNC with an FIO2 of 0.7-1.0 (flow rate: 40 L/min) improved oxygenation and was well-tolerated until the partial pressure of oxygen in blood/FIO2 ratio increased (between 21 and 26 days)...
March 2016: Respiratory Investigation
Shan Lyu, Youzhong An
Actively heated, humidified high flow nasal cannula oxygen therapy (HFNC) is a new type of oxygen therapy. Because of its unique physiological effects, the clinical application is becoming more and more popular. This article is to summarize the physiological effects, clinical application and short comings of HFNC. Compared with conventional oxygen therapy, HFNC helps to improve oxygenation better, and it is more comfortable than non-invasive ventilation (NIV) in use. Proper use of HFNC may be able to reduce the use of NIV and decrease the rate of endotracheal intubation...
January 2016: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
J Bräunlich, G Nilius
The therapy of choice in hypoxemic respiratory failure (type 1) is the application of supplemental oxygen at flow rates of 1 to 15 l/min via nasal prongs or mask. Non-invasive or invasive positive pressure ventilation will be initiated when the oxygen therapy effects are not sufficient or if hypercapnic respiratory failure (type 2) is the underlying problem. Recently, an alternative therapy option is available, from the pathophysiology it can be classified between oxygen therapy and positive pressure ventilation...
January 2016: Pneumologie
Peter Reynolds, Stamatina Leontiadi, Tracy Lawson, Tosin Otunla, Olayinka Ejiwumi, Nicola Holland
OBJECTIVE: This was a pilot study to determine the feasibility of using nasal high flow (nHF) (also known as heated humidified high-flow nasal cannula) for stabilisation of babies born at <30 weeks gestation in the delivery room (DR) and transfer to the neonatal intensive care unit (NICU). DESIGN: Observational study. SETTING: Single-centre NICU. PATIENTS: Infants born at <30 weeks gestation. INTERVENTIONS: Stabilisation and transfer to NICU using nHF...
July 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Yusuke Chikata, Kazuaki Unai, Masayo Izawa, Nao Okuda, Jun Oto, Masaji Nishimura
BACKGROUND: High-flow nasal cannula (HFNC) therapy provides better humidification than conventional oxygen therapy. To allay loss of vapor as condensation, a servo-controlled heating wire is incorporated in the inspiratory tube, but condensation is not completely avoidable. We investigated factors that might affect condensation: thermal characteristics of the inspiratory tube, HFNC flow, and ambient temperature. METHODS: We evaluated 2 types of HFNC tubes, SLH Flex 22-mm single tube and RT202...
March 2016: Respiratory Care
Jia Chen, Wei-Wei Gao, Fang Xu, Lan-Lan Du, Tao Zhang, Xing Ling, Wei-Tao Li
OBJECTIVE: To compare the differences of clinical efficacy between heated humidified high-flow nasal cannula (HHHFNC) ventilation and nasal continuous positive airway pressure (NCPAP) in the treatment of respiratory distress syndrome (RDS) in very low birth weight (VLBW) infants. METHODS: A total of 66 VLBW infants who were admitted to the neonatal intensive care unit were diagnosed with RDS, and they were randomly assigned to HHHFNC group and NCPAP group after receiving treatment with porcine pulmonary surfactant and conventional treatment...
August 2015: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
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