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Effect of high-flow nasal cannula on thoraco-abdominal synchrony in adult critically ill patients.
Respir Care. 2014 Jan; 59(1):70-4.RC

Abstract

BACKGROUND

High-flow nasal cannula (HFNC) creates positive oropharyngeal airway pressure and improves oxygenation. It remains unclear, however, whether HFNC improves thoraco-abdominal synchrony in patients with mild to moderate respiratory failure. Using respiratory inductive plethysmography, we investigated the effects of HFNC on thoraco-abdominal synchrony.

METHODS

We studied 40 adult subjects requiring oxygen therapy in the ICU. Low-flow oxygen (up to 8 L/min) was administered via oronasal mask for 30 min, followed by HFNC at 30-50 L/min. Respiratory inductive plethysmography transducer bands were circumferentially placed: one around the rib cage, and one around the abdomen. We measured the movement of the rib-cage and abdomen, and used the sum signal to represent tidal volume (V(T)) during mask breathing, and at 30 min during HFNC. We calculated the ratio of maximum compartmental amplitude (MCA) to V(T), and the phase angle. We assessed arterial blood gas and vital signs at each period, and mouth status during HFNC. We used multiple regression analysis to identify factors associated with improvement in thoraco-abdominal synchrony.

RESULTS

During HFNC, breathing frequency significantly decreased from 25 breaths/min (IQR 22-27 breaths/min) to 21 breaths/min (IQR 18-24 breaths/min) (P < .001), and MCA/VT (P < .001) and phase angle (P = .047) significantly improved.

CONCLUSIONS

HFNC improved thoraco-abdominal synchrony in adult subjects with mild to moderate respiratory failure.

Authors+Show Affiliations

Department of Emergency and Critical Care Medicine, University of Tokushima Graduate School.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

23737548

Citation

Itagaki, Taiga, et al. "Effect of High-flow Nasal Cannula On Thoraco-abdominal Synchrony in Adult Critically Ill Patients." Respiratory Care, vol. 59, no. 1, 2014, pp. 70-4.
Itagaki T, Okuda N, Tsunano Y, et al. Effect of high-flow nasal cannula on thoraco-abdominal synchrony in adult critically ill patients. Respir Care. 2014;59(1):70-4.
Itagaki, T., Okuda, N., Tsunano, Y., Kohata, H., Nakataki, E., Onodera, M., Imanaka, H., & Nishimura, M. (2014). Effect of high-flow nasal cannula on thoraco-abdominal synchrony in adult critically ill patients. Respiratory Care, 59(1), 70-4. https://doi.org/10.4187/respcare.02480
Itagaki T, et al. Effect of High-flow Nasal Cannula On Thoraco-abdominal Synchrony in Adult Critically Ill Patients. Respir Care. 2014;59(1):70-4. PubMed PMID: 23737548.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of high-flow nasal cannula on thoraco-abdominal synchrony in adult critically ill patients. AU - Itagaki,Taiga, AU - Okuda,Nao, AU - Tsunano,Yumiko, AU - Kohata,Hisakazu, AU - Nakataki,Emiko, AU - Onodera,Mutsuo, AU - Imanaka,Hideaki, AU - Nishimura,Masaji, Y1 - 2013/06/04/ PY - 2013/6/6/entrez PY - 2013/6/6/pubmed PY - 2014/10/1/medline KW - acute respiratory failure KW - critical care KW - high-flow oxygen therapy KW - nasal cannula KW - respiratory inductive plethysmography KW - thoraco-abdominal synchrony SP - 70 EP - 4 JF - Respiratory care JO - Respir Care VL - 59 IS - 1 N2 - BACKGROUND: High-flow nasal cannula (HFNC) creates positive oropharyngeal airway pressure and improves oxygenation. It remains unclear, however, whether HFNC improves thoraco-abdominal synchrony in patients with mild to moderate respiratory failure. Using respiratory inductive plethysmography, we investigated the effects of HFNC on thoraco-abdominal synchrony. METHODS: We studied 40 adult subjects requiring oxygen therapy in the ICU. Low-flow oxygen (up to 8 L/min) was administered via oronasal mask for 30 min, followed by HFNC at 30-50 L/min. Respiratory inductive plethysmography transducer bands were circumferentially placed: one around the rib cage, and one around the abdomen. We measured the movement of the rib-cage and abdomen, and used the sum signal to represent tidal volume (V(T)) during mask breathing, and at 30 min during HFNC. We calculated the ratio of maximum compartmental amplitude (MCA) to V(T), and the phase angle. We assessed arterial blood gas and vital signs at each period, and mouth status during HFNC. We used multiple regression analysis to identify factors associated with improvement in thoraco-abdominal synchrony. RESULTS: During HFNC, breathing frequency significantly decreased from 25 breaths/min (IQR 22-27 breaths/min) to 21 breaths/min (IQR 18-24 breaths/min) (P < .001), and MCA/VT (P < .001) and phase angle (P = .047) significantly improved. CONCLUSIONS: HFNC improved thoraco-abdominal synchrony in adult subjects with mild to moderate respiratory failure. SN - 1943-3654 UR - https://www.unboundmedicine.com/medline/citation/23737548/Effect_of_high_flow_nasal_cannula_on_thoraco_abdominal_synchrony_in_adult_critically_ill_patients_ L2 - http://rc.rcjournal.com/cgi/pmidlookup?view=short&amp;pmid=23737548 DB - PRIME DP - Unbound Medicine ER -