[High flow, humidified-reheated oxygen therapy: a new oxygenation technique for adults].

Abstract:

:Currently conventional oxygen therapy is the first choice symptomatic treatment in the management of acute respiratory failure (ARF). However, conventional oxygen therapy has important limitations which have lead to the development of heated and humidified high-flow nasal oxygen therapy (HFNO). HFNO is an innovative technique that can deliver, through special nasal cannulae, up to 100% of the inspired fraction (FiO2) with heated and humidified oxygen at a maximum flow of 70L/min. The characteristics of this technique (overcoming the patient's spontaneous inspiratory flow, heated humidification,) and its physiological effects (no dilution of FiO2, positive end-expiratory pressure, pharyngeal dead-space washout, decrease in airway resistance), allow efficient optimization of oxygenation with better tolerance for patients. Current data, mainly observational, show that HFNO could be used particularly for the management of hypoxemic ARF, notably in the more severe forms. Indications for using HFNO, alone or in association with noninvasive ventilation, are potentially very broad and may involve different types of ARF (post-operative, post-extubation, palliative care) and even the practice of invasive technical procedures (bronchial fibroscopy). However, though current studies are very encouraging and promise a clinical benefit on patient outcomes, randomized trials are still needed to demonstrate that HFNO avoids the need for endotracheal intubation in the management of ARF.

journal_name

Rev Mal Respir

authors

Frat JP,Goudet V,Girault C

doi

10.1016/j.rmr.2013.04.016

subject

Has Abstract

pub_date

2013-10-01 00:00:00

pages

627-43

issue

8

eissn

0761-8425

issn

1776-2588

pii

S0761-8425(13)00126-5

journal_volume

30

pub_type

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