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Research ArticleOriginal Research

High-Flow Oxygen Therapy in Acute Respiratory Failure

Oriol Roca, Jordi Riera, Ferran Torres and Joan R Masclans
Respiratory Care April 2010, 55 (4) 408-413;
Oriol Roca
Intensive Care Medicine Department, Hospital Universitari Vall d'Hebron (Àrea General), Barcelona, Spain.
Respiratory Medicine Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain.
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  • For correspondence: [email protected]
Jordi Riera
Intensive Care Medicine Department, Hospital Universitari Vall d'Hebron (Àrea General), Barcelona, Spain.
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Ferran Torres
Laboratori de Bioestadística i Epidemiologia, Universitat Autònoma de Barcelona
Servei de Farmacología Clínica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain.
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Joan R Masclans
Intensive Care Medicine Department, Hospital Universitari Vall d'Hebron (Àrea General), Barcelona, Spain.
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Abstract

OBJECTIVE: To compare the comfort of oxygen therapy via high-flow nasal cannula (HFNC) versus via conventional face mask in patients with acute respiratory failure. Acute respiratory failure was defined as blood oxygen saturation < 96% while receiving a fraction of inspired oxygen ≥ 0.50 via face mask.

METHODS: Oxygen was first humidified with a bubble humidifier and delivered via face mask for 30 min, and then via HFNC with heated humidifier for another 30 min. At the end of each 30-min period we asked the patient to evaluate dyspnea, mouth dryness, and overall comfort, on a visual analog scale of 0 (lowest) to 10 (highest). The results are expressed as median and interquartile range values.

RESULTS: We included 20 patients, with a median age of 57 (40–70) years. The total gas flow administered was higher with the HFNC than with the face mask (30 [21.3–38.7] L/min vs 15 [12–20] L/min, P < .001). The HFNC was associated with less dyspnea (3.8 [1.3–5.8] vs 6.8 [4.1–7.9], P = .001) and mouth dryness (5 [2.3–7] vs 9.5 [8–10], P < .001), and was more comfortable (9 [8–10]) versus 5 [2.3–6.8], P < .001). HFNC was associated with higher PaO2 (127 [83–191] mm Hg vs 77 [64–88] mm Hg, P = .002) and lower respiratory rate (21 [18–27] breaths/min vs 28 [25–32] breaths/min, P < .001), but no difference in PaCO2.

CONCLUSIONS: HFNC was better tolerated and more comfortable than face mask. HFNC was associated with better oxygenation and lower respiratory rate. HFNC could have an important role in the treatment of patients with acute respiratory failure.

  • acute respiratory failure
  • respiratory insufficiency
  • treatment
  • oxygen therapy
  • high-flow nasal cannula

Footnotes

  • Correspondence: Oriol Roca MD, Servei de Medicina Intensiva (Àrea General), Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain. E-mail: oroca{at}ir.vhebron.net.
  • Dr Roca and Dr Masclans have disclosed relationships with Fisher & Paykel Healthcare. Dr Riera and Dr Torres have disclosed no conflicts of interest.

  • See the Related Editorial on Page 485

  • Copyright © 2010 by Daedalus Enterprises Inc.
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Respiratory Care: 55 (4)
Respiratory Care
Vol. 55, Issue 4
1 Apr 2010
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High-Flow Oxygen Therapy in Acute Respiratory Failure
Oriol Roca, Jordi Riera, Ferran Torres, Joan R Masclans
Respiratory Care Apr 2010, 55 (4) 408-413;

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High-Flow Oxygen Therapy in Acute Respiratory Failure
Oriol Roca, Jordi Riera, Ferran Torres, Joan R Masclans
Respiratory Care Apr 2010, 55 (4) 408-413;
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Keywords

  • acute respiratory failure
  • respiratory insufficiency
  • treatment
  • oxygen therapy
  • High-flow nasal cannula

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