Safety and Efficacy of Early Ambulation on an Alternative Oxygen Delivery Device for Patients Receiving Bedside Heated Humidified High-Flow Nasal Cannula Therapy

Abstract

Purpose: Patients in the intensive care unit (ICU) receiving heated humidified high-flow nasal cannula (HHFNC) therapy for acute respiratory failure have limited ambulation distance due to restrictions in supplying HHFNC away from bedside. This study investigated the safety and efficacy of transitioning patients requiring HHFNC to a portable high-flow oxygen (HFO2) device for ambulation. Methods: Twenty-three patients with acute respiratory failure participated in this prospective longitudinal observational study. Three diagnostic groups were formed (cardiac n = 8; pulmonary n = 11; and other n = 4). Initial aerobic tolerance was established through bedside marching on HHFNC, then participants transitioned to HFO2 for ambulation. During each phase, vital signs were monitored. Results: No differences were found among diagnostic groups or sexes during ambulation for blood pressure, heart rate (HR), respiratory rate (RR), oxygen saturation (SpO2), or the Borg dyspnea scale (BDS) (all P > .05). Outcomes during marching and ambulation differed from outcomes at rest and during recovery for HR, RR, SpO2, and BDS (all P < .001). Transitory adverse events during ambulation included anxiety (n = 2), hypotension (n = 1), and arrhythmia (n = 2). Conclusions: Results indicate it is safe and efficacious for patients in the ICU with acute respiratory failure requiring HHFNC to ambulate on HFO2 under the supervision of a physical therapist.