The use of high-flow oxygen therapy delivered via Airvo™ in the acute setting over a six-month period: A clinical perspective

Abstract

Since 2010 the benefits of high-flow oxygen therapy (HFOT) have been realised both in the acute clinical setting and for chronic long-term conditions. Independent control of flow, inspired oxygen and humidification, and reports of good patient tolerance, makes it a favourable treatment option. A service review looking at the use of HFOT delivered via Airvo™ (Fisher and Paykel) was completed over a six-month period in the acute clinical environment in a small tertiary hospital in New Zealand. It was used on the critical care unit, but its use focused primarily at ward level to determine which patients could benefit from it and to indicate where it could be safely delivered. Data was collected on patient diagnosis, clinical indications, respiratory rate, oxygen percentage and mode of delivery prior to using high-flow, initial HFOT settings and highest settings throughout treatment, number of HFOT treatment days and clinical outcome. In this report, clinical observations showed that for those patients who have secretion retention, atelectasis, increased work of breathing, and increasing oxygen requirements, HFOT is an appropriate treatment option especially in those patients who are not reliant on high levels of positive end expiratory pressure (PEEP). It also demonstrated that HFOT via Airvo™ can be safely implemented in ward settings for a variety of clinical conditions. Recommendations for future work includes the collection of qualitative data on patient comfort and compliance with HFOT in addition to information on clinician confidence in setting up and weaning patients from the device.