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Review ArticleNarrative Review

High-Flow Nasal Cannula and COVID-19: A Clinical Review

Claudia Crimi, Paola Pierucci, Teresa Renda, Lara Pisani and Annalisa Carlucci
Respiratory Care September 2022, respcare.09056; DOI: https://doi.org/10.4187/respcare.09056
Claudia Crimi
Respiratory Medicine Unit, “Policlinico-Vittorio Emanuele-San Marco,” University Hospital, Catania, Italy.
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  • For correspondence: [email protected]
Paola Pierucci
Respiratory Medicine Unit, Policlinico “Aldo Moro” University Hospital, Bari, Italy.
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Teresa Renda
Respiratory and Critical Care Unit, Cardio-thoracic and Vascular Department, Careggi Teaching Hospital, Florence, Italy.
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Lara Pisani
Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, University Hospital Sant’Orsola-Malpighi, Bologna, Italy.
Department of Clinical, Integrated and Experimental Medicine, Alma Mater Studiorum University, Bologna, Italy.
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Annalisa Carlucci
Department of Medicine and Surgery, Università Insubria, Varese-Como, Italy.
Pulmonary Rehabilitation Unit, Istituti Clinici Scientifici Maugeri, Pavia, Italy.
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Abstract

During the coronavirus disease 2019 (COVID-19) pandemic, noninvasive respiratory support has played a central role in managing patients affected by moderate-to-severe acute hypoxemic respiratory failure, despite inadequate scientific evidence to support its usage. High-flow nasal cannula (HFNC) treatment has gained tremendous popularity because of its effectiveness in delivering a high fraction of humidified oxygen, which improves ventilatory efficiency and the respiratory pattern, as well as its reported high tolerability, ease of use, and application outside of ICUs. Nevertheless, the risk of infection transmission to health-care workers has raised some concerns about its use in the first wave of the pandemic outbreak, with controversial recommendations provided by different scientific societies. This narrative review provides an overview of the recent evidence on the physiologic rationale, risks, and benefits of using HFNC instead of conventional oxygen therapy and other types of noninvasive respiratory support devices, such as continuous positive airway pressure and noninvasive ventilation in patients affected by COVID-19 pneumonia with associated acute hypoxemic respiratory failure. It also summarizes the available evidence with regard to the clinical use of HFNC during the current pandemic and its reported outcomes, and highlights the risks of bioaerosol dispersion associated with HFNC use.

  • High-flow nasal cannula
  • COVID-19
  • SARS-CoV-2
  • acute hypoxemic respiratory failure
  • ARDS

Footnotes

  • Correspondence: Claudia Crimi MD PhD, Respiratory Medicine Unit, A.O.U. “Policlinico-Vittorio Emanuele-San Marco,” Via S. Sofia, 78, 95123, Catania, Italy. E-mail: dott.claudiacrimi{at}gmail.com
  • Copyright © 2021 by Daedalus Enterprises
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Respiratory Care: 68 (6)
Respiratory Care
Vol. 68, Issue 6
1 Jun 2023
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High-Flow Nasal Cannula and COVID-19: A Clinical Review
Claudia Crimi, Paola Pierucci, Teresa Renda, Lara Pisani, Annalisa Carlucci
Respiratory Care Sep 2022, respcare.09056; DOI: 10.4187/respcare.09056

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High-Flow Nasal Cannula and COVID-19: A Clinical Review
Claudia Crimi, Paola Pierucci, Teresa Renda, Lara Pisani, Annalisa Carlucci
Respiratory Care Sep 2022, respcare.09056; DOI: 10.4187/respcare.09056
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Keywords

  • high-flow nasal cannula
  • COVID-19
  • SARS-CoV-2
  • acute hypoxemic respiratory failure
  • ARDS

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