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Review ArticleInvited Review

High-Flow Nasal Cannula Oxygen Therapy in Adults: Physiological Benefits, Indication, Clinical Benefits, and Adverse Effects

Masaji Nishimura
Respiratory Care April 2016, 61 (4) 529-541; DOI: https://doi.org/10.4187/respcare.04577
Masaji Nishimura
Department of Emergency and Critical Care Medicine, Tokushima University Graduate School, Kuramoto, Tokushima, Japan.
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  • For correspondence: nmasaji@tokushima-u.ac.jp
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    Fig. 1.

    Basic setup for high-flow nasal cannula oxygen delivery. An air-oxygen blender, allowing from 0.21 to 1.0 FIO2, generates up to 60 L/min flow. The gas is heated and humidified through an active heated humidifier and delivered via a single-limb heated inspiratory circuit. The patient breathes adequately heated and humidified medical gas through large-diameter nasal cannulas. (Modified from Reference 9.)

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    Fig. 2.

    Electrical output of the hotplate of an MR850 heated humidifier with an MR290 water chamber (both from Fisher & Paykel). The MR850 was set to maintain temperature at the water chamber outlet at 37°C and at the distal end of the inspiratory limb at 40°C. When flow was 60 L/min, electrical output was always 100%.

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    Fig. 3.

    Breathing frequency and PaCO2: comparison between high-flow nasal cannula oxygen therapy (HFNC) and comparative therapies in 8 studies. Left: Difference of breathing frequency between comparative therapy and HFNC. In all studies, breathing frequency with HFNC was lower. Right: Difference of PaCO2. Here, no statistically significant differences between the therapies are apparent.

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Respiratory Care: 61 (4)
Respiratory Care
Vol. 61, Issue 4
1 Apr 2016
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High-Flow Nasal Cannula Oxygen Therapy in Adults: Physiological Benefits, Indication, Clinical Benefits, and Adverse Effects
Masaji Nishimura
Respiratory Care Apr 2016, 61 (4) 529-541; DOI: 10.4187/respcare.04577

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High-Flow Nasal Cannula Oxygen Therapy in Adults: Physiological Benefits, Indication, Clinical Benefits, and Adverse Effects
Masaji Nishimura
Respiratory Care Apr 2016, 61 (4) 529-541; DOI: 10.4187/respcare.04577
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  • Article
    • Abstract
    • Introduction
    • Adverse Effects of Lack of Humidification
    • Humidification Performance of HFNC Devices
    • Interface
    • Physiological Effect
    • Fraction of Inspired Oxygen
    • PEEP Effect
    • Clinical Trials
    • Hypercapnic Respiratory Failure
    • Hypoxemic Respiratory Failure
    • Postextubation
    • Preintubation Oxygenation
    • Acute Heart Failure
    • Sleep Apnea
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Keywords

  • noninvasive ventilation
  • high-flow oxygen therapy
  • escalation
  • randomized
  • controlled trials
  • humidification

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