| Age | Initiate Flow | Increase Flow By | Upper Limit of Flow (for Acute Care Floors) | Hypoxic </= 90% Saturation |
| 0-30 days | 4 LPM | 2 LPM for severe distress | Flow >8LPM and/or Fi02 >/= 60% | Start Fi02 at 40% and increase as needed to keep oxygen saturation >90% |
| >1 month- 2 years | 6 LPM | 2 LPM for severe distress | Flow >12LPM and/or Fi02 >/= 60% | Start Fi02 at 40% and increase as needed to keep oxygen saturation >90% |
| > 2 years- 6 years | 8 LPM | 2 LPM for severe distress | Flow >14LPM and/or Fi02 >/= 60% | Start Fi02 at 40% and increase as needed to keep oxygen saturation >90% |
Note: If patient does not have increased work of breathing or hypoxemic respiratory failure (decrease in oxygen level in blood due to respiratory failure), consider other low flow modalities prior to the initiation of HiVNI. Flow may be limited by cannula or cartridge based on manufacture recommendations.