Safety and efficacy of high flow nasal canula in patients with mild hypercapnia

Abstract

ContextHigh flow nasal canula is usually used for management of acute hypoxemic failure; however, it may have a potential therapeutic benefits in hypercapnia as it can alter tidal volume, end expiratory volume, positive end expiratory pressure, and respiratory rate.AimEvaluate safety and efficacy of application HFNC (high flow nasal canula) for patients with mild hypercapnia.Settings and designA prospective interventional study.Patients and methodsOver six months, thirty eight patients were enrolled, with mild hypercapnia and PH level not less 7.30 and PaCo2 not more 60 mmhg; with applying HFNC, serial checking of arterial blood gases was done. Checkpoints were at 2 h, 12 h, 24 h, and 48 h post application of HFNC. HFNC can be shifted to NIV or invasive MV at any time whenever indicated.ResultsPrimary pulmonary disorder was chronic obstructive pulmonary disorder in (22 patients) and (16 patients) had interstitial lung disease. For PH in overall, mean values had changed from 7.33 until reached 7.37 at 48 h post HFNC with calculation of P value at each checkpoint from baseline value; significant changes were recorded at 24 h and 48 h post HFNC application. A similar observation was observed for PaCO2. No significant changes were observed at any checkpoint for HCO3.ConclusionHigh flow nasal canula is safe in cases with mild hypercapnia with a considerable success rate and a proven high efficacy.Trial registrationClinicaltrials.gov/NCT05948527, Registered 14 July 2023—Retrospectively registered, https://www.clinicaltrials.gov/NCT05948527.