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Comparison between the effect of heated and humidified high-flow nasal oxygen and conventional oxygen during acute hypoxemic respiratory failure

Egyptian Journal of Bronchology volume 11, pages 224–230 (2017)Cite this article

Abstract

Background

Hypoxemia is the most serious threat to organ function. Therefore, the goal is to reverse tissue hypoxia. The aim of this study was to compare heated and humidified high-flow nasal cannula (HFNC) with conventional low-flow nasal cannula (LFNC) oxygen therapy in acute hypoxemic respiratory failure (RF).

Patients and methods

This prospective study was conducted on 60 patients with acute hypoxemic RF. Patients were randomly classified into two groups. Group I received LFNC oxygen therapy. Group II received heated humidified HFNC oxygen therapy. Comparison between the two groups was made using dyspnea scales, heart rate, respiratory rate, and oxygenation status.

Results

There were no statistically significant differences as regards age, sex, smoking status, causes of RF, and presence of comorbidities between the two groups. There was no statistically significant difference in the modified Borg scale and visual analog scale (VAS) score between the two groups at baseline (P>0.05). After 24 h, the HFNC group had a significant decrease in these scores (P<0.05).

Respiratory rate and heart rate significantly decreased, whereas arterial oxygen saturation and tension increased significantly in the HFNC group compared with the conventional LFNC group (P<0.05).

Only one patient in the HFNC group versus three patients in the LFNC group required mechanical ventilation. Two patients experienced nasal discomfort in the HFNC group versus five patients in the LFNC group.

Conclusion

Treatment of acute hypoxemic RF with HFNC was associated with better and rapid improvement in oxygenation when compared with LFNC, with fewer side effects, better convenience, and lesser need for mechanical ventilation.

References

  1. Loscalzo J. Harrison’s pulmonary and critical care medicine. 2nd ed. New York, USA: McGraw Hill Professional; 2013.

  2. Kane B, Decalmer S, O’Driscoll BR. Emergency oxygen therapy: from guideline to implementation. Breathe 2013; 9:246–253.

    Article  Google Scholar 

  3. Yoo JW, Synn A, Huh JW, Hong SB, Koh Y, Lim CM. Clinical efficacy of high-flow nasal cannula compared to noninvasive ventilation in patients with post-extubation respiratory failure. Korean J Int Med 2016; 31:82–88.

    Article  CAS  Google Scholar 

  4. Ricard JD. High flow nasal oxygen in acute respiratory failure. Minerva Anestesiol 2012; 78:836–841.

    Google Scholar 

  5. Wettstein RB, Shelledy DC, Peters JI. Delivered oxygen concentrations using low-flow and high-flow nasal cannulas. Respir Care 2005; 50:604–609.

    PubMed  Google Scholar 

  6. Benditt JO. Adverse effects of low-flow oxygen therapy. Respir Care 2000; 45:54–61.

    CAS  PubMed  Google Scholar 

  7. White G. Equipment theory for respiratory care. 5th ed. New York USA: Delmar Cengage Learning; 2014.

  8. Spoletini G, Alotaibi M, Blasi F, Hill NS. Heated humidified high-flow nasal oxygen in adults: mechanisms of action and clinical implications. Chest 2015; 148:253–261.

    Article  Google Scholar 

  9. Sim MA, Dean P, Kinsella J, Black R, Carter R, Hughes M. Performance of oxygen delivery devices when the breathing pattern of respiratory failure is simulated. Anaesthesia 2008; 63:938–940.

    Article  CAS  Google Scholar 

  10. Cuquemelle E, Pham T, Papon JF, Louis B, Danin PE, Brochard L. Heated and humidified high-flow oxygen therapy reduces discomfort during hypoxemic respiratory failure. Respir Care 2012; 57:1571–1577.

    Article  Google Scholar 

  11. Chidekel A, Zhu Y, Wang J, Mosko JJ, Rodriguez E, Shaffer TH. The effects of gas humidification with high-flow nasal cannula on cultured human airway epithelial cells. Pulm Med 2012; 2012:1–8.

    Article  Google Scholar 

  12. El-Khatib MF. High-flow nasal cannula oxygen therapy during hypoxemic respiratory failure. Respir Care 2012; 57:1696–1698.

  13. Waugh J, Granger W. An evaluation of 2 new devices for nasal high-flow gas therapy. Respir Care 2004; 49:902–906.

    PubMed  Google Scholar 

  14. Ritchie JE, Williams AB, Gerard C, Hockey H. Evaluation of a humidified nasal high-flow oxygen system, using oxygraphy, capnography and measurement of upper airway pressures. Anaesth Intensive Care 2011; 39:1103–1110.

    Article  CAS  Google Scholar 

  15. Chanques G, Riboulet F, Molinari N, Carr J, Jung B, Prades A, et al. Comparison of three high flow oxygen therapy delivery devices: a clinical physiological cross-over study. Minerva Anestesiol 2013; 79: 1344–1355.

    CAS  PubMed  Google Scholar 

  16. Gotera C, Díaz Lobato S, Pinto T, Winck JC. Clinical evidence on high flow oxygen therapy and active humidification in adults. Rev Port Pneumol 2013; 19:217–227.

    Article  CAS  Google Scholar 

  17. Dani C, Pratesi S, Migliori C, Bertini G High flow nasal cannula therapy as respiratory support in the preterm infant. Pediatr Pulmonol 2009; 44:629–634.

  18. Kendrick KR, Baxi SC, Smith RM. Usefulness of the modified 0–10 Borg scale in assessing the degree of dyspnea in patients with COPD and asthma. J Emerg Nurs 2000; 26:216–222.

    Article  CAS  Google Scholar 

  19. Martinez JAB, Martinez TY, Galhardo FPL, Pereira CAD. Dyspnea scales as a measure of health-related quality of life in patients with idiopathic pulmonary fibrosis. Med Sci Monit 2002; 8:CR405–CR410.

    PubMed  Google Scholar 

  20. Ward JJ. High-flow oxygen administration by nasal cannula for adult and perinatal patients. Respir Care 2013; 58:98–122.

    Article  Google Scholar 

  21. Sotello D, Rivas M, Mulkey Z, Nugent K. High-flow nasal cannula oxygen in adult patients: a narrative review. Am J Med Sci 2015; 349:179–185.

    Article  Google Scholar 

  22. Restrepo RD, Walsh BK. Humidification during invasive and noninvasive mechanical ventilation: 2012. Respir Care 2012; 57:782–788.

    Article  Google Scholar 

  23. Frat JP, Brugiere B, Ragot S, Chatellier D, Veinstein A, Goudet V, et al. Sequential application of oxygen therapy via high-flow nasal cannula and noninvasive ventilation in acute respiratory failure: an observational pilot study. Respir Care 2015; 60:170–178.

    Article  Google Scholar 

  24. Rittayamai N, Tscheikuna J, Rujiwit P. High-flow nasal oxygen cannula versus conventional oxygen therapy after endotracheal extubation: a randomized crossover physiologic study. Respir Care 2014; 59: 485–490.

    Article  Google Scholar 

  25. Lenglet H, Sztrymf B, Leroy C, Brun P, Dreyfuss D, Ricard JD. Humidified high flow nasal oxygen during respiratory failure in the Emergency Department: feasibility and efficacy. Respir Care 2012; 57:1873–1878.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Chest Diseases, Tanta University Hospital, Tanta, 33633, Egypt

    Ghada A. Attia & Adel S. Bediwy

  2. Emergency Medicine and Traumatology, Faculty of Medicine, Tanta University, Tanta, Egypt

    Radwa M. Ashour

Authors
  1. Ghada A. Attia
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  2. Adel S. Bediwy
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  3. Radwa M. Ashour
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Corresponding author

Correspondence to Adel S. Bediwy.

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Attia, G.A., Bediwy, A.S. & Ashour, R.M. Comparison between the effect of heated and humidified high-flow nasal oxygen and conventional oxygen during acute hypoxemic respiratory failure. Egypt J Bronchol 11, 224–230 (2017). https://doi.org/10.4103/1687-8426.211399

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  • DOI: https://doi.org/10.4103/1687-8426.211399

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