Journal ArticleDOI
High flow nasal cannula for adult acute hypoxemic respiratory failure in the ED setting.
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TLDR
In this paper, the authors evaluated the utility of high flow nasal cannula (HFNC) in adult patients with acute hypoxemic respiratory failure in the ED setting, including pneumonia, acute respiratory distress syndrome (ARDS), coronavirus disease 2019 (COVID-19), interstitial lung disease, immunocompromised states, and palliative care, with reduced need for intubation, length of stay and mortality in some of these conditions.Abstract:
Introduction High flow nasal cannula (HFNC) is a noninvasive ventilation (NIV) system that has demonstrated promise in the emergency department (ED) setting. Objective This narrative review evaluates the utility of HFNC in adult patients with acute hypoxemic respiratory failure in the ED setting. Discussion HFNC provides warm (37 °C), humidified (100% relative humidity) oxygen at high flows with a reliable fraction of inspired oxygen (FiO2). HFNC can improve oxygenation, reduce airway resistance, provide humidified flow that can flush anatomical dead space, and provide a low amount of positive end expiratory pressure. Recent literature has demonstrated efficacy in acute hypoxemic respiratory failure, including pneumonia, acute respiratory distress syndrome (ARDS), coronavirus disease 2019 (COVID-19), interstitial lung disease, immunocompromised states, the peri-intubation state, and palliative care, with reduced need for intubation, length of stay, and mortality in some of these conditions. Individual patient factors play an important role in infection control risks with respect to the use of HFNC in patients with COVID-19. Appropriate personal protective equipment, adherence to hand hygiene, surgical mask placement over the HFNC device, and environmental controls promoting adequate room ventilation are the foundation for protecting healthcare personnel. Frequent reassessment of the patient placed on HFNC is necessary; those with severe end organ dysfunction, thoracoabdominal asynchrony, significantly increased respiratory rate, poor oxygenation despite HFNC, and tachycardia are at increased risk of HFNC failure and need for further intervention. Conclusions HFNC demonstrates promise in several conditions requiring respiratory support. Further randomized trials are needed in the ED setting.read more
Citations
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A clinical comparative study of an intelligent IoT-based HFNC device to provide respiratory support for patients with acute respiratory failure:a multi-center prospective controlled study (Preprint)
TL;DR: Wang et al. as mentioned in this paper developed a remote management platform for respiratory equipment using the latest Internet of Things (IoT) and big data analysis technologies, which provided precise oxygen therapy to patients with respiratory failure, but also supported physicians in analyzing conditions, enacting parameter settings, and issuing early sickness warnings.
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Efficacy and safety of high-flow nasal cannula therapy in elderly patients with acute respiratory failure
José Manuel Carratalá,Salvador Díaz-Lobato,Benjamin Brouzet,P. Más-Serrano,Judith Rocamora,A. G. Castro,A.G. Varela,S. Mayoralas Alises +7 more
TL;DR: In this article , the efficacy and safety of high-flow nasal cannula (HFNC) in elderly patients with acute respiratory failure (ARF) not due to COVID-19, refractory to treatment with conventional oxygen therapy and/or intolerant to continuous positive airway pressure (CPAP) and without criteria for admission to intensive care units (ICU).
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Journal ArticleDOI
High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure.
Jean-Pierre Frat,Arnaud W. Thille,Alain Mercat,Christophe Girault,Stéphanie Ragot,Sébastien Perbet,Gwenaël Prat,Thierry Boulain,Elise Morawiec,Alice Cottereau,Jérôme Devaquet,Saad Nseir,Keyvan Razazi,Jean-Paul Mira,Laurent Argaud,Jean-Charles Chakarian,Jean-Damien Ricard,Xavier Wittebole,Stéphanie Chevalier,Alexandre Herbland,Muriel Fartoukh,Jean-Michel Constantin,Jean-Marie Tonnelier,Marc Pierrot,Armelle Mathonnet,Gaetan Beduneau,Celine Deletage-Metreau,Jean-Christophe M. Richard,Laurent Brochard,René Robert +29 more
TL;DR: In patients with nonhypercapnic acute hypoxemic respiratory failure, treatment with high-flow oxygen, standard oxygen, or noninvasive ventilation did not result in significantly different intubation rates, and there was a significant difference in favor of high- flow oxygen in 90-day mortality.
Journal ArticleDOI
Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure
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TL;DR: This document provides European Respiratory Society/American Thoracic Society and ERS/ATS evidence-based recommendations for the use of noninvasive ventilation in acute respiratory failure based on the most current literature.