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Nasal high-flow oxygen therapy in patients with hypoxic respiratory failure: effect on functional and subjective respiratory parameters compared to conventional oxygen therapy and non-invasive ventilation (NIV).
BMC Anesthesiol. 2014; 14:66.BA

Abstract

BACKGROUND

Aim of the study was to compare the short-term effects of oxygen therapy via a high-flow nasal cannula (HFNC) on functional and subjective respiratory parameters in patients with acute hypoxic respiratory failure in comparison to non-invasive ventilation (NIV) and standard treatment via a Venturi mask.

METHODS

Fourteen patients with acute hypoxic respiratory failure were treated with HFNC (FiO2 0.6, gas flow 55 l/min), NIV (FiO2 0.6, PEEP 5 cm H2O Hg, tidal volume 6-8 ml/kg ideal body weight,) and Venturi mask (FiO2 0.6, oxygen flow 15 l/min,) in a randomized order for 30 min each. Data collection included objective respiratory and circulatory parameters as well as a subjective rating of dyspnea and discomfort by the patients on a 10-point scale. In a final interview, all three methods were comparatively evaluated by each patient using a scale from 1 (=very good) to 6 (=failed) and the patients were asked to choose one method for further treatment.

RESULTS

PaO2 was highest under NIV (129 ± 38 mmHg) compared to HFNC (101 ± 34 mmHg, p <0.01 vs. NIV) and VM (85 ± 21 mmHg, p <0.001 vs. NIV, p <0.01 vs. HFNC, ANOVA). All other functional parameters showed no relevant differences. In contrast, dyspnea was significantly better using a HFNC (2.9 ± 2.1, 10-point Borg scale) compared to NIV (5.0 ± 3.3, p <0.05), whereas dyspnea rating under HFNC and VM (3.3 ± 2.3) was not significantly different. A similar pattern was found when patients rated their overall discomfort on the 10 point scale: HFNC 2.7 ± 1.8, VM 3.1 ± 2.8 (ns vs. HFNC), NIV 5.4 ± 3.1 (p <0.05 vs. HFNC). In the final evaluation patients gave the best ratings to HFNC 2.3 ± 1.4, followed by VM 3.2 ± 1.7 (ns vs. HFNC) and NIV 4.5 ± 1.7 (p <0.01 vs. HFNC and p <0.05 vs. VM). For further treatment 10 patients chose HFNC, three VM and one NIV.

CONCLUSIONS

In hypoxic respiratory failure HFNC offers a good balance between oxygenation and comfort compared to NIV and Venturi mask and seems to be well tolerated by patients.

TRIAL REGISTRATION

GERMAN CLINICAL TRIALS REGISTER: DRKS00005132.

Links

PMC Free PDF

Authors+Show Affiliations

Schwabbauer N
Department of Internal Medicine, Medical Intensive Care Unit, University of Tübingen, Otfried-Müller-Str, 10, Tübingen 72076, Germany.
Berg B
Department of Internal Medicine, Medical Intensive Care Unit, University of Tübingen, Otfried-Müller-Str, 10, Tübingen 72076, Germany.
Blumenstock G
Department of Clinical Epidemiology and Applied Biometry, University of Tübingen, Tübingen, Germany.
Haap M
Department of Internal Medicine, Medical Intensive Care Unit, University of Tübingen, Otfried-Müller-Str, 10, Tübingen 72076, Germany.
Hetzel J
Department of Internal Medicine, Division of Pulmonary Medicine, University of Tübingen, Tübingen, Germany.
Riessen R
Department of Internal Medicine, Medical Intensive Care Unit, University of Tübingen, Otfried-Müller-Str, 10, Tübingen 72076, Germany.

MeSH

AdolescentAdultAgedAged, 80 and overDyspneaFemaleHemodynamicsHumansHypoxiaMaleMasksMiddle AgedNoninvasive VentilationOxygen ConsumptionOxygen Inhalation TherapyRespiratory Function TestsRespiratory Insufficiency

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25110463

Clinical Trial Links

Rehabilitation With HHFNC in COPD in Nocturnal NIV
High Flow Nasal Cannula in the Emergency Department
Low Creatinine Level and Respiratory Failure

Citation

Schwabbauer, Norbert, et al. "Nasal High-flow Oxygen Therapy in Patients With Hypoxic Respiratory Failure: Effect On Functional and Subjective Respiratory Parameters Compared to Conventional Oxygen Therapy and Non-invasive Ventilation (NIV)." BMC Anesthesiology, vol. 14, 2014, p. 66.
Schwabbauer N, Berg B, Blumenstock G, et al. Nasal high-flow oxygen therapy in patients with hypoxic respiratory failure: effect on functional and subjective respiratory parameters compared to conventional oxygen therapy and non-invasive ventilation (NIV). BMC Anesthesiol. 2014;14:66.
Schwabbauer, N., Berg, B., Blumenstock, G., Haap, M., Hetzel, J., & Riessen, R. (2014). Nasal high-flow oxygen therapy in patients with hypoxic respiratory failure: effect on functional and subjective respiratory parameters compared to conventional oxygen therapy and non-invasive ventilation (NIV). BMC Anesthesiology, 14, 66. https://doi.org/10.1186/1471-2253-14-66
Schwabbauer N, et al. Nasal High-flow Oxygen Therapy in Patients With Hypoxic Respiratory Failure: Effect On Functional and Subjective Respiratory Parameters Compared to Conventional Oxygen Therapy and Non-invasive Ventilation (NIV). BMC Anesthesiol. 2014;14:66. PubMed PMID: 25110463.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nasal high-flow oxygen therapy in patients with hypoxic respiratory failure: effect on functional and subjective respiratory parameters compared to conventional oxygen therapy and non-invasive ventilation (NIV). AU - Schwabbauer,Norbert, AU - Berg,Björn, AU - Blumenstock,Gunnar, AU - Haap,Michael, AU - Hetzel,Jürgen, AU - Riessen,Reimer, Y1 - 2014/08/07/ PY - 2013/12/22/received PY - 2014/7/25/accepted PY - 2014/8/12/entrez PY - 2014/8/12/pubmed PY - 2015/4/18/medline KW - High-flow nasal cannula KW - Non-invasive ventilation KW - Oxygen KW - Respiratory failure KW - Venturi mask SP - 66 EP - 66 JF - BMC anesthesiology JO - BMC Anesthesiol VL - 14 N2 - BACKGROUND: Aim of the study was to compare the short-term effects of oxygen therapy via a high-flow nasal cannula (HFNC) on functional and subjective respiratory parameters in patients with acute hypoxic respiratory failure in comparison to non-invasive ventilation (NIV) and standard treatment via a Venturi mask. METHODS: Fourteen patients with acute hypoxic respiratory failure were treated with HFNC (FiO2 0.6, gas flow 55 l/min), NIV (FiO2 0.6, PEEP 5 cm H2O Hg, tidal volume 6-8 ml/kg ideal body weight,) and Venturi mask (FiO2 0.6, oxygen flow 15 l/min,) in a randomized order for 30 min each. Data collection included objective respiratory and circulatory parameters as well as a subjective rating of dyspnea and discomfort by the patients on a 10-point scale. In a final interview, all three methods were comparatively evaluated by each patient using a scale from 1 (=very good) to 6 (=failed) and the patients were asked to choose one method for further treatment. RESULTS: PaO2 was highest under NIV (129 ± 38 mmHg) compared to HFNC (101 ± 34 mmHg, p <0.01 vs. NIV) and VM (85 ± 21 mmHg, p <0.001 vs. NIV, p <0.01 vs. HFNC, ANOVA). All other functional parameters showed no relevant differences. In contrast, dyspnea was significantly better using a HFNC (2.9 ± 2.1, 10-point Borg scale) compared to NIV (5.0 ± 3.3, p <0.05), whereas dyspnea rating under HFNC and VM (3.3 ± 2.3) was not significantly different. A similar pattern was found when patients rated their overall discomfort on the 10 point scale: HFNC 2.7 ± 1.8, VM 3.1 ± 2.8 (ns vs. HFNC), NIV 5.4 ± 3.1 (p <0.05 vs. HFNC). In the final evaluation patients gave the best ratings to HFNC 2.3 ± 1.4, followed by VM 3.2 ± 1.7 (ns vs. HFNC) and NIV 4.5 ± 1.7 (p <0.01 vs. HFNC and p <0.05 vs. VM). For further treatment 10 patients chose HFNC, three VM and one NIV. CONCLUSIONS: In hypoxic respiratory failure HFNC offers a good balance between oxygenation and comfort compared to NIV and Venturi mask and seems to be well tolerated by patients. TRIAL REGISTRATION: GERMAN CLINICAL TRIALS REGISTER: DRKS00005132. SN - 1471-2253 UR - https://www.unboundmedicine.com/medline/citation/25110463/Nasal_high_flow_oxygen_therapy_in_patients_with_hypoxic_respiratory_failure:_effect_on_functional_and_subjective_respiratory_parameters_compared_to_conventional_oxygen_therapy_and_non_invasive_ventilation__NIV__ DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓61 ↑25]

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