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. 2014 Aug 7:14:66.
doi: 10.1186/1471-2253-14-66. eCollection 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)

Norbert Schwabbauer  1 , Björn Berg  1 , Gunnar Blumenstock  2 , Michael Haap  1 , Jürgen Hetzel  3 , Reimer Riessen  1
Affiliations

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)

Norbert Schwabbauer et al. BMC Anesthesiol. .

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.

Keywords: High-flow nasal cannula; Non-invasive ventilation; Oxygen; Respiratory failure; Venturi mask.

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Figures

Figure 1
Figure 1
Flowchart. During the intervention patients were treated in a randomized order with either high-flow nasal cannula (HFNC), Venturi-mask (VM) or with none - invasive ventilation (NIV).
See this image and copyright information in PMC

References

    1. O'Driscoll BR, Howard LS, Davison AG. BTS guideline for emergency oxygen use in adult patients. Thorax. 2008;63(Suppl 6):vi1–vi68. - PubMed
    1. Armstrong JAM, Guleria A, Girling K. Evaluation of gas exchange deficit in the critically ill. Contin Educ Anaesth Crit Care Pain. 2007;7(4):131–134.
    1. Kallstrom TJ. AARC Clinical Practice Guideline: oxygen therapy for adults in the acute care facility–2002 revision & update. Respir Care. 2002;47(6):717–720. - PubMed
    1. El Khatib MF. High-flow nasal cannula oxygen therapy during hypoxemic respiratory failure. Respir Care. 2012;57(10):1696–1698. - PubMed
    1. Wagstaff TA, Soni N. Performance of six types of oxygen delivery devices at varying respiratory rates. Anaesthesia. 2007;62(5):492–503. - PubMed