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Review
. 2023 Jan 31;3(1):20-26.
doi: 10.1016/j.jointm.2022.07.005. Epub 2022 Sep 29.

High-flow nasal cannula oxygen therapy in acute hypoxemic respiratory failure and COVID-19-related respiratory failure

Jean-Pierre Frat  1   2 , Laura Marchasson  1 , François Arrivé  1 , Rémi Coudroy  1   2
Affiliations
Review

High-flow nasal cannula oxygen therapy in acute hypoxemic respiratory failure and COVID-19-related respiratory failure

Jean-Pierre Frat et al. J Intensive Med. .

Abstract

Although standard oxygen face masks are first-line therapy for patients with acute hypoxemic respiratory failure, high-flow nasal cannula oxygen therapy has gained major popularity in intensive care units. The physiological effects of high-flow oxygen counterbalance the physiological consequences of acute hypoxemic respiratory failure by lessening the deleterious effects of intense and prolonged inspiratory efforts generated by patients. Its simplicity of application for physicians and nurses and its comfort for patients are other arguments for its use in this setting. Although clinical studies have reported a decreased risk of intubation with high-flow oxygen compared with standard oxygen, its survival benefit is uncertain. A more precise definition of acute hypoxemic respiratory failure, including a classification of severity based on oxygenation levels, is needed to better compare the efficiencies of different non-invasive oxygenation support methods (standard oxygen, high-flow oxygen, and non-invasive ventilation). Additionally, the respective role of each non-invasive oxygenation support method needs to be established through further clinical trials in acute hypoxemic respiratory failure, especially in severe forms.

Keywords: Acute respiratory failure; COVID-19; High-flow nasal oxygen; Oxygen support.

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Conflict of interest statement

Jean-Pierre Frat reports travel expenses coverage to attend scientific meetings and consulting fees from Fisher&Paykel and SOS oxygen; Laura Marchasson and François Arrivé report no conflicts of interest; Rémi Coudroy reports travel expenses coverage to attend scientific meetings from Fisher&Paykel and MSD, grants from ERS and SRLF.

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