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Oxygen Supplementation: High-Flow Nasal Oxygen

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Pulmonary Function Measurement in Noninvasive Ventilatory Support

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Abstract

High-flow nasal cannula (HFNC) oxygen supplementation has several physiological advantages compared with other standard oxygen therapies, including washing out anatomical dead space, generation of positive airway pressure, providing constant oxygen concentrations, and optimal heating and humidification of delivered gas. HFNC has emerged as an effective modality for early treatment of adults with respiratory failure with diverse underlying diseases. This chapter covers the mechanisms of HFNC and its potential use in common clinical settings.

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Abbreviations

AHRF:

Acute hypoxemic respiratory failure

ARDS:

Acute respiratory disease syndrome

CO2:

Carbon dioxide

COT:

Conventional oxygen therapy

COVID-19:

Coronavirus disease-19

CPAP:

Continuous positive airway pressure

FiO2:

Fraction of inspired oxygen

HFNC:

High-flow nasal cannula

ICU:

Intensive care unit

NIPPV:

Noninvasive positive-pressure ventilation

O2:

Oxygen

PaO2:

Partial pressure of arterial oxygen

PEEP:

Positive end expiratory pressure

SpO2:

Arterial oxygen saturation

WHO:

World Health Organization

References

  1. Kallstrom T. ARC Clinical Practice Guideline: oxygen therapy for adults in the acute care facility – 2002 revision & update. Respir Care. 2002;47:717–20.

    PubMed  Google Scholar 

  2. Ricard J, Boyer A. Humidification during oxygen therapy and non-invasive ventilation: do we need some and how much? Intensive Care Med. 2009;35:963–5.

    Article  Google Scholar 

  3. Vargas F, Saint-Leger M, Boyer A, et al. Physiologic effects of high-flow nasal cannula oxygen in critical care subjects. Respir Care. 2015;60:1369–76.

    Article  Google Scholar 

  4. Frat JP, Thille AW, Mercat A, et al. High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. N Engl J Med. 2015;372:2185–96.

    Article  CAS  Google Scholar 

  5. Ou X, Hua Y, Liu J, et al. Effect of high-flow nasal cannula oxygen therapy in adults with acute hypoxemic respiratory failure: a meta-analysis of randomized controlled trials. CMAJ. 2017;189(7):E260–7.

    Article  Google Scholar 

  6. Monro-Somerville T, Sim M, Ruddy J, et al. The effect of high-flow nasal cannula oxygen therapy on mortality and intubation rate in acute respiratory failure. Crit Care Med. 2017;45:e449–56.

    Article  Google Scholar 

  7. Panadero C, Abad-Fernández A, Rio-Ramirez T, et al. High-flow nasal cannula for Acute Respiratory Distress Syndrome (ARDS) due to COVID-19. Multidiscip Respir Med. 2020;15:693–8.

    Article  Google Scholar 

  8. Mauri T, Alban L, Turrini C, et al. Optimum support by high-flow nasal cannula in acute hypoxemic respiratory failure: effects of increasing flow rates. Intensive Care Med. 2017;43(10):1453–63.

    Article  CAS  Google Scholar 

  9. Wang D, Hu B, Hu C. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061–9.

    Article  CAS  Google Scholar 

  10. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054–62.

    Article  CAS  Google Scholar 

  11. Patel M, Gangemi A, Marron R, et al. Retrospective analysis of high flow nasal therapy in COVID-19-related moderate-to-severe hypoxaemic respiratory failure. BMJ Open Resp Res. 2020;7:e000650. https://doi.org/10.1136/bmjresp-2020-000650.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Vogelsinger H, Halank M, Braun S, et al. Efficacy and safety of nasal high-flow oxygen in COPD patients. BMC Pulm Med. 17(1):143–50.

    Google Scholar 

  13. Storgaard LH, Hockey HU, Laursen BS, et al. Long-term effects of oxygen-enriched high-flow nasal cannula treatment in COPD patients with chronic hypoxemic respiratory failure. Int J Chron Obstruct Pulmon Dis. 2018;13:1195–205.

    Article  CAS  Google Scholar 

  14. Roca O, Pérez-Terán P, Masclans JR, et al. Patients with New York Heart Association class III heart failure may benefit with high flow nasal cannula supportive therapy: high flow nasal cannula in heart failure. J Crit Care. 2013;28:741–6.

    Article  Google Scholar 

  15. Rello J, Pe’rez M, Roca O, et al. High-flow nasal therapy in adults with severe acute respiratory infection: a cohort study in patients with 2009 influenza A/H1N1. J Crit Care. 2012;27:434–9.

    Article  Google Scholar 

  16. Roca O, Messika J, Caralt B, et al. Predicting success of high-flow nasal cannula in pneumonia patients with hypoxemic respiratory failure: The utility of the ROX index. J Crit Care. 2016;35:200–5.

    Article  Google Scholar 

  17. Lucangelo U, Vassallo FG, Marras E, et al. High-flow nasal interface improves oxygenation in patients undergoing bronchoscopy. Crit Care Res Prac. 2012;2012:506382. https://doi.org/10.1155/2012/506382.

    Article  Google Scholar 

  18. Simon M, Wachs C, Braune S, et al. High-flow nasal cannula versus bag-valve-mask for preoxygenation before intubation in subjects with hypoxemic respiratory failure. Respir Care. 2016;61(9):1160–7.

    Article  Google Scholar 

  19. Miguel-Montanes R, Hajage D, Messika J, et al. Use of high-flow nasal cannula oxygen therapy to prevent desaturation during tracheal intubation of intensive care patients with mild-to-moderate hypoxemia. Crit Care Med. 2015;43:574–83.

    Article  CAS  Google Scholar 

  20. Fong KM, Au SY, Ng GWY. Preoxygenation before intubation in adult patients with acute hypoxemic respiratory failure: a network meta-analysis of randomized trials. Crit Care. 2019;23(1):319–30.

    Article  Google Scholar 

  21. Stéphan F, Barrucand B, Petit P, et al. High-flow nasal oxygen vs noninvasive positive airway pressure in hypoxemic patients after cardiothoracic surgery. JAMA. 2015;313:2331–9.

    Article  Google Scholar 

  22. Maggiore SM, Idone FA, Vaschetto R, et al. Nasal high-flow versus venturi mask oxygen therapy after extubation. Effects on oxygenation, comfort, and clinical outcome. Am J Respir Crit Care Med. 2014;190:282–8.

    Article  Google Scholar 

  23. Di Mussi R, Spadaro S, Stripoli T, et al. High-flow nasal cannula oxygen therapy decreases postextubation neuroventilatory drive and work of breathing in patients with chronic obstructive pulmonary disease. Crit Care. 2018;22(1):180–90.

    Article  Google Scholar 

  24. McGinley BM, Patil SP, Kirkness JP, et al. A nasal cannula can be used to treat obstructive sleep apnea. Am J Respir Crit Care Med. 2007;176(2):194–200.

    Article  Google Scholar 

  25. Lemiale V, Resche-Rigon M, Mokart D, et al. High-flow nasal cannula oxygenation in immunocompromised patients with acute hypoxemic respiratory failure: a Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique Study. Crit Care Med. 2017;45(3):e274–80.

    Article  Google Scholar 

  26. Tu G, He H, Yin K, et al. High-flow nasal cannula versus noninvasive ventilation for treatment of acute hypoxemic respiratory failure in renal transplant recipients. Transplant Proc. 2017;49(6):1325–30.

    Article  CAS  Google Scholar 

  27. Epstein AS, Hartridge-Lambert SK, Ramaker JS, et al. Humidified high-flow nasal oxygen utilization in patients with cancer at Memorial Sloan-Kettering Cancer Center. J Palliat Med. 2011;14:835–9.

    Article  Google Scholar 

  28. Peters SG, Holets SR, Gay PC. High-flow nasal cannula therapy in do-not-intubate patients with hypoxemic respiratory distress. Respir Care. 2013;58:597–600.

    PubMed  Google Scholar 

  29. Macé J, Marjanovic N, Faranpour F, et al. Early high-flow nasal cannula oxygen therapy in adults with acute hypoxemic respiratory failure in the ED: a before-after study. Am J Emerg Med. 2019;37(11):2091–6.

    Article  Google Scholar 

  30. Lenglet H, Sztrymf B, Leroy C, et al. Humidified high flow nasal oxygen during respiratory failure in the emergency department: feasibility and efficacy. Respir Care. 2012;57(11):1873–8.

    Article  Google Scholar 

  31. Nishimura M. High-flow nasal cannula oxygen therapy in adults: physiological benefits, indication, clinical benefits, and adverse effects. Respir Care. 2016;61(4):529–41.

    Article  Google Scholar 

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Authors and Affiliations

  1. Division of Respiratory Therapy, Department of Anesthesiology, American University of Beirut—Medical Center, Beirut, Lebanon

    Mohamad F. El-Khatib

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  1. Mohamad F. El-Khatib
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Correspondence to Mohamad F. El-Khatib .

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Editors and Affiliations

  1. Intensive Care Unit, Hospital General Universitario Morales Meseguer, Murcia, Spain

    Antonio M. Esquinas

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El-Khatib, M.F. (2021). Oxygen Supplementation: High-Flow Nasal Oxygen. In: Esquinas, A.M. (eds) Pulmonary Function Measurement in Noninvasive Ventilatory Support. Springer, Cham. https://doi.org/10.1007/978-3-030-76197-4_29

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  • DOI: https://doi.org/10.1007/978-3-030-76197-4_29

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-76196-7

  • Online ISBN: 978-3-030-76197-4

  • eBook Packages: MedicineMedicine (R0)

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