High Flow Nasal Cannula Oxygen in Adults: An Evidence-Based Assessment.
Ann Am Thorac Soc. 2017 Nov 16;:
Authors: Drake MG
High flow nasal cannula oxygenation has distinct advantages over other oxygen devices due to its unique effects on respiratory physiology. In particular, adjustable oxygen delivery and flow-dependent carbon dioxide clearance from the upper airway reduce work of breathing and can better match inspiratory demand during respiratory distress. Historically, few studies had evaluated whether the physiologic effects of these devices translated into clinical benefit. However, recent publications have begun to address this knowledge gap. High flow nasal cannula oxygenation has been shown to have similar, and in some cases superior, clinical efficacy compared to conventional low flow oxygen supplementation and non-invasive positive pressure ventilation in acute hypoxemic respiratory failure. High flow nasal cannula oxygenation also prevents reintubations in medical and post-operative surgical populations, and has been used to provide pre-oxygenation for laryngoscopy and to support oxygenation during bronchoscopy. This review evaluates recent evidence for high flow nasal cannula oxygenation in adults, including its physiological effects and clinical indications. Since many clinical indications have not been studied, clinicians and physiologists must have a thorough understanding of device titration to tailor therapy for specific clinical scenarios.
PMID: 29144160 [PubMed - as supplied by publisher]