Physiologic Effects of High-Flow Nasal Cannula in Healthy Subjects.
BACKGROUND: High-flow nasal cannula (HFNC) is increasingly used in the management of acute and chronic respiratory failure. Little is known about the optimal settings for HFNC. This study was designed to assess the dose effect of HFNC on respiratory effort indexes and respiratory patterns in spontan...
| Publicado en: | Respiratory Care Vol. 65; no. 9; pp. 1346 - 1355 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts tracings randomized controlled trial Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Sep2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=145308246&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 145308246 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Sep2020 vid: 65 iid: 9 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 145308246 145308246 145308246 10.4187/respcare.07306 145308246 ppf: 1346 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Physiologic Effects of High-Flow Nasal Cannula in Healthy Subjects. aug: au: Delorme, Mathieu Bouchard, Pierre-Alexandre Simon, Mathieu Simard, Serge Lellouche, François affil: Université Paris-Saclay, UVSQ, ERPHAN, Versailles France sug: subj: Respiratory Failure Therapy Respiration, Artificial Respiration Physiology Nasal Cannula Oxygenation Evaluation Human Male Female Adult Randomized Controlled Trials Random Assignment Crossover Design Multiple Linear Regression Data Analysis Software Descriptive Statistics Esophagus Physiology Work of Breathing Blood Gas Analysis Dose-Response Relationship Lung Volume Measurements Plethysmography Carbon Dioxide Blood One-Way Analysis of Variance Adult: 19-44 years Male Female ab: BACKGROUND: High-flow nasal cannula (HFNC) is increasingly used in the management of acute and chronic respiratory failure. Little is known about the optimal settings for HFNC. This study was designed to assess the dose effect of HFNC on respiratory effort indexes and respiratory patterns in spontaneously breathing adults. METHODS: A randomized controlled crossover study was conducted in 10 healthy subjects. Five experimental conditions were evaluated: baseline with no therapy; 5 L/min with conventional nasal prongs; and HFNC at 20, 40, and 60 L/min. The primary outcomes were the indexes of respiratory effort (ie, esophageal pressure swing [ΔPes], esophageal pressure-time product, and work of breathing). Secondary outcomes included breathing pattern parameters and blood gases. Dead-space ventilation and washout were calculated based on minute ventilation, breathing frequency, and Radford equations. RESULTS: ΔPes increased from median (interquartile range [IQR] 3.2 (2.2-3.6) cm H2O at baseline to median (IQR) 5.7 (4.6-6.8) cm H2O at 60 L/min (P < .001). Neither esophageal pressure-time product nor work of breathing were modified during the tested conditions. The minute volume was significantly reduced at 40 and 60 L/min compared with baseline (P = .04), mostly driven by an important and dose-dependent reduction in breathing frequency, from median (IQR) 16 (15-18) breaths/min at baseline, to median (IQR) 8 (7-10) breaths/min at 60 L/min (P < .001). Capillary P... was stable in all the tested conditions. The calculated dead-space ventilation was reduced by half with HFNC. Conclusions: HFNC did not significantly modify work of breathing in healthy subjects. However, a significant reduction in the minute volume was achieved, capillary P... remaining constant, which suggests a reduction in dead-space ventilation with flows > 20 L/min. (ClinicalTrials.gov registration NCT02495675). pubtype: Academic Journal doctype: research tables/charts tracings randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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