Physiologic Effects of High-Flow Nasal Cannula Oxygen in Critical Care Subjects.

INTRODUCTION: High-flow nasal cannula (HFNC) can deliver heated and humidified gas (up to 100% oxygen) at a maximum flow of 60 L/min via nasal prongs or cannula. The aim of this study was to assess the short-term physiologic effects of HFNC. Inspiratory muscle effort, gas exchange, dyspnea score, an...

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Publicado en:Respiratory Care Vol. 60; no. 10; pp. 1369 - 1377
Autores principales: Vargas, Frederic, Saint-Leger, Mélanie, Boyer, Alexandre, Nam H. Bui, Hilbert, Gilles
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Oct2015
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Mary Ann Liebert, Inc.
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        atl: Physiologic Effects of High-Flow Nasal Cannula Oxygen in Critical Care Subjects.
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        au:
          Vargas, Frederic
          Saint-Leger, Mélanie
          Boyer, Alexandre
          Nam H. Bui
          Hilbert, Gilles
        affil: Service de Réanimation Médicale, Hôpital Pellegrin-Tripode, Bordeaux, France
      sug:
        subj:
          Critically Ill Patients
          Nasal Cannula
          Oxygen Therapy Utilization
          Human
          Continuous Positive Airway Pressure
          Friedman Test
          Wilcoxon Signed Rank Test
          Repeated Measures
          Matched-Pair Analysis
          Post Hoc Analysis
          Male
          Female
          Middle Age
          Aged
          Aged, 80 and Over
          Funding Source
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: INTRODUCTION: High-flow nasal cannula (HFNC) can deliver heated and humidified gas (up to 100% oxygen) at a maximum flow of 60 L/min via nasal prongs or cannula. The aim of this study was to assess the short-term physiologic effects of HFNC. Inspiratory muscle effort, gas exchange, dyspnea score, and comfort were evaluated. METHODS: Twelve subjects admitted to the ICU for acute hypoxemic respiratory failure were prospectively included. Four study sessions were performed. The first session consisted of oxygen therapy given through a high-FIO2, non-rebreathing face mask. Recordings were then obtained during periods of HFNC and CPAP at 5 cm H2O in random order, and final measurements were performed during oxygen therapy delivered via a face mask. Each of these 4 periods lasted ~20 min. RESULTS: Esophageal pressure signals, breathing pattern, gas exchange, comfort, and dyspnea were measured. Compared with the first session, HFNC reduced inspiratory effort (pressure-time product of 156.0 [119.2-194.4] cm H2O X s/min vs 204.2 [149.6-324.7] cmH2O X s/min, P < .01) and breathing frequency (P < .01). No significant differences were observed between HFNC and CPAP for inspiratory effort and breathing frequency. Compared with the first session, PaO2/FIO2 increased significantly with HFNC (167 [157-184] mm Hg vs 156 [110-171] mm Hg, P < .01). CPAP produced significantly greater PaO2/FIO2 improvement than did HFNC. Dyspnea improved with HFNC and CPAP, but this improvement was not significant. Subject comfort was not different across the 4 sessions. CONCLUSIONS: Compared with conventional oxygen therapy, HFNC improved inspiratory effort and oxygenation. In subjects with acute hypoxemic respiratory failure, HFNC is an alternative to conventional oxygen therapy.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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