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Physiologic Effects of High-Flow Nasal Cannula Oxygen in Critical Care Subjects.
Respir Care. 2015 Oct; 60(10):1369-76.RC

Abstract

INTRODUCTION

High-flow nasal cannula (HFNC) can deliver heated and humidified gas (up to 100% oxygen) at a maximum flow of 60 L/min via nasal prongs or cannula. The aim of this study was to assess the short-term physiologic effects of HFNC. Inspiratory muscle effort, gas exchange, dyspnea score, and comfort were evaluated.

METHODS

Twelve subjects admitted to the ICU for acute hypoxemic respiratory failure were prospectively included. Four study sessions were performed. The first session consisted of oxygen therapy given through a high-FIO2, non-rebreathing face mask. Recordings were then obtained during periods of HFNC and CPAP at 5 cm H2O in random order, and final measurements were performed during oxygen therapy delivered via a face mask. Each of these 4 periods lasted ∼20 min.

RESULTS

Esophageal pressure signals, breathing pattern, gas exchange, comfort, and dyspnea were measured. Compared with the first session, HFNC reduced inspiratory effort (pressure-time product of 156.0 [119.2-194.4] cm H2O × s/min vs 204.2 [149.6-324.7] cm H2O × s/min, P < .01) and breathing frequency (P < .01). No significant differences were observed between HFNC and CPAP for inspiratory effort and breathing frequency. Compared with the first session, PaO2/FIO2 increased significantly with HFNC (167 [157-184] mm Hg vs 156 [110-171] mm Hg, P < .01). CPAP produced significantly greater PaO2/FIO2 improvement than did HFNC. Dyspnea improved with HFNC and CPAP, but this improvement was not significant. Subject comfort was not different across the 4 sessions.

CONCLUSIONS

Compared with conventional oxygen therapy, HFNC improved inspiratory effort and oxygenation. In subjects with acute hypoxemic respiratory failure, HFNC is an alternative to conventional oxygen therapy. (ClinicalTrials.gov registration NCT01056952.).

Authors+Show Affiliations

Service de Réanimation Médicale, Hôpital Pellegrin-Tripode, Bordeaux, France. Centre de Recherche Cardio-thoracique, CIC 0005, Université de Bordeaux, Bordeaux, France. frederic.vargas@chu-bordeaux.fr.Service de Réanimation Médicale, Hôpital Pellegrin-Tripode, Bordeaux, France.Service de Réanimation Médicale, Hôpital Pellegrin-Tripode, Bordeaux, France.Service de Réanimation Médicale, Hôpital Pellegrin-Tripode, Bordeaux, France.Service de Réanimation Médicale, Hôpital Pellegrin-Tripode, Bordeaux, France. Centre de Recherche Cardio-thoracique, CIC 0005, Université de Bordeaux, Bordeaux, France.

Pub Type(s)

Comparative Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25944940

Citation

Vargas, Frederic, et al. "Physiologic Effects of High-Flow Nasal Cannula Oxygen in Critical Care Subjects." Respiratory Care, vol. 60, no. 10, 2015, pp. 1369-76.
Vargas F, Saint-Leger M, Boyer A, et al. Physiologic Effects of High-Flow Nasal Cannula Oxygen in Critical Care Subjects. Respir Care. 2015;60(10):1369-76.
Vargas, F., Saint-Leger, M., Boyer, A., Bui, N. H., & Hilbert, G. (2015). Physiologic Effects of High-Flow Nasal Cannula Oxygen in Critical Care Subjects. Respiratory Care, 60(10), 1369-76. https://doi.org/10.4187/respcare.03814
Vargas F, et al. Physiologic Effects of High-Flow Nasal Cannula Oxygen in Critical Care Subjects. Respir Care. 2015;60(10):1369-76. PubMed PMID: 25944940.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Physiologic Effects of High-Flow Nasal Cannula Oxygen in Critical Care Subjects. AU - Vargas,Frederic, AU - Saint-Leger,Mélanie, AU - Boyer,Alexandre, AU - Bui,Nam H, AU - Hilbert,Gilles, Y1 - 2015/05/05/ PY - 2015/5/7/entrez PY - 2015/5/7/pubmed PY - 2016/7/7/medline KW - acute hypoxemic respiratory failure KW - continuous positive airway pressure KW - high-flow nasal cannula KW - inspiratory effort KW - oxygen therapy SP - 1369 EP - 76 JF - Respiratory care JO - Respir Care VL - 60 IS - 10 N2 - INTRODUCTION: High-flow nasal cannula (HFNC) can deliver heated and humidified gas (up to 100% oxygen) at a maximum flow of 60 L/min via nasal prongs or cannula. The aim of this study was to assess the short-term physiologic effects of HFNC. Inspiratory muscle effort, gas exchange, dyspnea score, and comfort were evaluated. METHODS: Twelve subjects admitted to the ICU for acute hypoxemic respiratory failure were prospectively included. Four study sessions were performed. The first session consisted of oxygen therapy given through a high-FIO2, non-rebreathing face mask. Recordings were then obtained during periods of HFNC and CPAP at 5 cm H2O in random order, and final measurements were performed during oxygen therapy delivered via a face mask. Each of these 4 periods lasted ∼20 min. RESULTS: Esophageal pressure signals, breathing pattern, gas exchange, comfort, and dyspnea were measured. Compared with the first session, HFNC reduced inspiratory effort (pressure-time product of 156.0 [119.2-194.4] cm H2O × s/min vs 204.2 [149.6-324.7] cm H2O × s/min, P < .01) and breathing frequency (P < .01). No significant differences were observed between HFNC and CPAP for inspiratory effort and breathing frequency. Compared with the first session, PaO2/FIO2 increased significantly with HFNC (167 [157-184] mm Hg vs 156 [110-171] mm Hg, P < .01). CPAP produced significantly greater PaO2/FIO2 improvement than did HFNC. Dyspnea improved with HFNC and CPAP, but this improvement was not significant. Subject comfort was not different across the 4 sessions. CONCLUSIONS: Compared with conventional oxygen therapy, HFNC improved inspiratory effort and oxygenation. In subjects with acute hypoxemic respiratory failure, HFNC is an alternative to conventional oxygen therapy. (ClinicalTrials.gov registration NCT01056952.). SN - 1943-3654 UR - https://www.unboundmedicine.com/medline/citation/25944940/Physiologic_Effects_of_High_Flow_Nasal_Cannula_Oxygen_in_Critical_Care_Subjects_ L2 - http://rc.rcjournal.com/cgi/pmidlookup?view=short&amp;pmid=25944940 DB - PRIME DP - Unbound Medicine ER -