Abstract
Introduction. High flow nasal cannula oxygen therapy (HFNC) has become frequent in the treatment of patients with acute hypoxemic respiratory failure. Methods. Eleven patients with acute exacerbation of fibrotic interstitial lung disease (ILD) were treated with HFNC after failure of conventional therapy (SatO 2 < 90% offering 100% FiO 2 by non-rebreathing mask or noninvasive ventilation). Results. Ten patients had success with HFNC (not requiring orotracheal intubation) during emergency department admission. HFNC significantly improves clinical variables after 2h: respiratory rate decreased from 33 ± 6 breaths/min to 23 ± 3 breaths/min; PaO 2 increased from 48.7 (38 - 59)mmHg to 81.1 (76 - 90) mmHg; PaO 2 /FiO 2 ratio increased from 102.4 ± 32.2 to 136.6 ± 29.4; SatO 2 increased from 85 (66 - 92)% to 96 ± (95 - 97)%. HFNC could be an effective alternative in the treatment of acute respiratory failure from acute exacerbations of fibrotic ILD.
Highlights
High flow nasal cannula oxygen therapy (HFNC) has become frequent in the treatment of patients with acute hypoxemic respiratory failure
HFNC has been commonly used in the treatment of patients with acute hypoxemic respiratory failure as it results in greater comfort and oxygenation than standard oxygen therapy delivered through a face mask, helping decrease the work of breathing[6]
HFNC was delivered using an Optiflow nasal interface and circuit connected to a heated humidifier (MR730; Fisher & Paykel Healthcare, Auckland, New Zealand) with flow generated through a mechanical ventilator with oxygen therapy software (EVITA XL, Dräger, Lübeck, Germany)
Summary
High flow nasal cannula oxygen therapy (HFNC) has become frequent in the treatment of patients with acute hypoxemic respiratory failure. HFNC might potentially be an alternative to conventional oxygen therapy in patients requiring both high flows and high oxygen concentrations, such as patients with acute exacerbation of fibrotic ILD, to correct hypoxemia and control dyspnea; evidence is still scarce[7]. In this prospective analysis, we assessed short-term effects (need for endotracheal intubation, clinical outcomes, arterial blood gases, and length of hospital stay) in patients with acute respiratory failure due to acute exacerbation of fibrotic ILD in the emergency department (ED)
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