Use of high-flow nasal cannula oxygenation in ICU adults: a narrative review

Papazian, Laurent, Corley, Amanda, Hess, Dean, Fraser, John F., Frat, Jean‑Pierre, Guitton, Christophe, Jaber, Samir, Maggiore, Salvatore M., Nava, Stefano, Rello, Jordi, Ricard, Jean‑Damien, Stephan, François, Trisolini, Rocco and Azoulay, Elie (2016) Use of high-flow nasal cannula oxygenation in ICU adults: a narrative review. Intensive Care Medicine, . doi:10.1007/s00134-016-4277-8

Author Papazian, Laurent
Corley, Amanda
Hess, Dean
Fraser, John F.
Frat, Jean‑Pierre
Guitton, Christophe
Jaber, Samir
Maggiore, Salvatore M.
Nava, Stefano
Rello, Jordi
Ricard, Jean‑Damien
Stephan, François
Trisolini, Rocco
Azoulay, Elie
Title Use of high-flow nasal cannula oxygenation in ICU adults: a narrative review
Journal name Intensive Care Medicine   Check publisher's open access policy
ISSN 1432-1238
Publication date 2016-03-11
Year available 2016
Sub-type Article (original research)
DOI 10.1007/s00134-016-4277-8
Open Access Status Not Open Access
Total pages 14
Place of publication Heidelberg, Germany
Publisher Springer
Collection year 2017
Language eng
Formatted abstract
Oxygen therapy can be delivered using low-flow, intermediate-flow (air entrainment mask), or high-flow devices. Low/intermediate-flow oxygen devices have several drawbacks that cause critically ill patients discomfort and translate into suboptimal clinical results. These include limitation of the FiO2 (due to the high inspiratory flow often observed in patients with respiratory failure), and insufficient humidification and warming of the inspired gas. High-flow nasal cannula oxygenation (HFNCO) delivers oxygen flow rates of up to 60 L/min and over the last decade its effect on clinical outcomes has widely been evaluated, such as in the improvement of respiratory distress, the need for intubation, and mortality. Mechanisms of action of HFNCO are complex and not limited to the increased oxygen flow rate. The main aim of this review is to guide clinicians towards evidence-based clinical practice guidelines. It summarizes current knowledge about HFNCO use in ICU patients and the potential areas of uncertainties. For instance, it has been recently suggested that HFNCO could improve the outcome of patients with hypoxemic acute respiratory failure. In other settings, research is ongoing and additional evidence is needed. For instance, if intubation is required, studies suggest that HFNCO may help to improve preoxygenation and can be used after extubation. Likewise, HFNCO might be used in obese patients, or to prevent respiratory deterioration in hypoxemic patients requiring bronchoscopy, or for the delivery of aerosol therapy. However, areas for which conclusive data exist are limited and interventions using standardized HFNCO protocols, comparators, and relevant clinical outcomes are warranted.
Keyword Acute respiratory failure
High-flow nasal cannula oxygenation
Non-invasive ventilation
Oxygen therapy
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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