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.).
journal_name
Respir Carejournal_title
Respiratory careauthors
Vargas F,Saint-Leger M,Boyer A,Bui NH,Hilbert Gdoi
10.4187/respcare.03814subject
Has Abstractpub_date
2015-10-01 00:00:00pages
1369-76issue
10eissn
0020-1324issn
1943-3654pii
respcare.03814journal_volume
60pub_type
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