Humidified High Flow Oxygen Therapy Research Articles

Analysis of the Efficacy of Humidified High-Flow Nasal Oxygen Therapy Combined with Alveolar Lavage in the Treatment of Patients with Severe Pneumonia Complicated with Respiratory Failure

Objective: To analyze the curative effect of humidified high-flow nasal oxygen therapy combined with alveolar lavage in patients with severe pneumonia and respiratory failure. Methods: 120 patients with severe pneumonia complicated with respiratory failure admitted to the Third People’s Hospital of Xining from July 2021 to December 2022 were randomly divided into two groups: group A and group B. The patients in group A were given humidified high-flow nasal oxygen therapy combined with alveolar lavage, whereas those in group B were given humidified high-flow nasal oxygen therapy. The treatment efficacy, blood gas analysis results, and differences in inflammatory mediators were compared between the two groups. Results: The curative effect in group A (96.67%) was significantly higher than that in group B (81.67%), P < 0.05; the partial pressure of carbon dioxide (PaCO2), partial pressure of oxygen (PaO2 ), oxygen saturation (SpO2 ), and Horowitz index (P/F) of group A were significantly better than group B, P < 0.05; the interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP) levels, white blood cell (WBC) count, serum procalcitonin (PCT), and neutrophil (N) percentage of group A were significantly lower than those of group B, P < 0.05. Conclusion: For patients with severe pneumonia complicated with respiratory failure, alveolar lavage, on the basis of humidified high-flow oxygen therapy, can inhibit local inflammation, improve blood gas analysis results, promote disease recovery, and improve the clinical treatment effect.

A nationwide survey on the use of heated humidified high flow oxygen therapy on the paediatric wards in the UK: current practice and research priorities

BackgroundHeated Humidified High Flow Nasal Cannula Oxygen Therapy (HHFNC) is increasingly used on the paediatric wards and High Dependency Units (HDU) for different types of pathologies and different age groups. We aimed to describe current practice related to the use of HHFNC on the paediatric wards and HDUs, weaning practices and preferred outcome measures for future research.MethodsWe carried out a cross-sectional online survey of UK paediatric consultants or their delegates working on the paediatric wards. Descriptive analysis of their geographical, and organizational characteristics, their specialties, and their level of experience was investigated. Reasons for HHFNC initiation, weaning criteria, patients’ characteristics and their primary pathologies were also analysed.ResultsParticipation of 218 paediatricians from 81 hospitals (Median: 2.7, Range: 1–11) was registered. HHFNC was provided in most of the surveyed hospitals (93%, 75/81). A High Dependency Unit (HDU) was available in 47 hospitals (58%); less than a third of those have a dedicated paediatrician. Decisions around HHFNC were made solely by paediatricians in (75%) of the cases, mostly at hospitals with no HDU compared to those with dedicated HDUs (70.3% VS 36.6, 95%CI:22.6–50.4%, P < .001). HHFNC was reported by nearly two-thirds (68%) of the practitioners who used it on the wards to be as effective or superior to CPAP (Continuous Positive Airway Pressure) with fewer complications. Failure rate while on HHFNC was identified as the most important outcome measure in any future research followed by the length of need for HHFNC support (37.1, and 28% respectively).ConclusionThis survey showed support for developing paediatric-specific national guidance on the use of HHFNC on the wards. Our list of defined research priorities may help guide further collaborative research efforts in this field.

Effect of high-flow nasal therapy during exercise training in COPD patients with chronic respiratory failure: study protocol for a randomised controlled trial

BackgroundThe benefit of pulmonary rehabilitation (PR) in symptomatic chronic obstructive pulmonary disease (COPD) is well known. However, advanced patients with chronic respiratory failure (CRF), a category excluded from most studies, are frequently unable to sustain a work-load sufficiently high to obtain the full benefit of PR on exercise tolerance. Recent studies involving heated and humidified high flow oxygen therapy (HFOT) showed positive effects on breathing pattern and ventilatory efficiency during effort. We thus plan to compare, in COPD patients with CRF undergoing a high-intensity exercise programme, the effect of using HFOT versus standard oxygen delivery via Venturi Mask (V-mask), at the same inspiratory oxygen fraction, on improving exercise endurance.Methods/DesignThis is a multicentre randomised controlled trial that will involve 156 COPD inpatients with CRF recruited from seven PR hospitals. Patients will be randomised to one of two groups – V-mask versus HFOT. All patients will undergo the same high-intensity exercise programme using either of the oxygen delivery devices as per their group allocation. Training will consist of 20 sessions, over 1 month (5 sessions per week) within the hospitalisation period. Anthropometric and clinical data, including body mass index, diagnosis, spirometry and comorbidities (Cumulative Rating Scale) will be collected at baseline. At baseline and at the end of the exercise programme (primary assessment time) evaluation will include exercise tolerance (Constant Work Rate Exercise Test) (primary outcome), functional capacity (6-min walk test), maximal inspiratory pressure/maximal expiratory pressure, peripheral muscle strength (biceps and quadriceps) by manual dynamometer, respiratory exchanges (blood gases analysis), disability (Barthel Index and Barthel Dyspnoea Index), impact of disease (COPD Assessment test), and quality of life (Maugeri Respiratory Failure Scale-26). At the end of the training period, patient satisfaction will be evaluated.DiscussionThis study will add knowledge about the exercise response in advanced COPD with CRF and verify if an alternative tool, namely HFOT, can increase the benefit obtained from PR.Trial registrationClinicalTrials.gov ID NET03322787Registered: 6 November 2017

Effects of humidified high flow oxygen therapy among patients with pulmonary fibrosis

Objective To explore the effects of heated humidified high flow nasal cannulae (HFNC) oxygen therapy among patients with pulmonary fibrosis. Methods A total of 60 patients in accord with diagnostics guide for idiopathic pulmonary fibrosis and admitted to Department of Respiratory at a Class III Grade A hospital in Tianjin for pulmonary fibrosis were selected by convenience sampling from May 2016 to March 2017. They received oxygen inhalation through nasal cannula for 24 hours and sequentially HFNC oxygen therapy for 24 hours respectively. The blood gas analysis, degree of comfort, severity of dyspnea and incidence of complications were compared two, four and twenty-four hours after adopting oxygen inhalation through nasal cannula and HFNC oxygen therapy. Results There were statistically significant differences in PaO2, SpO2, base excess (BE) and respiratory rate (RR) between oxygen inhalation through nasal cannula and HFNC oxygen therapy (P 0.05) . Conclusions The application of HFNC can increase PaO2 and SpO2, and slow RR among patients with pulmonary fibrosis. Meanwhile, it can also effectively improve the severity of dyspnea, promote patients′ comfort and reduce the incidence of complications. Key words: Humidification oxygen therapy with high flow capacity; Pulmonary fibrosis

P148 The Use of Heated Humidified High Flow Oxygen Therapy in the Palliative Setting: Developing a Practice Support Document for Use in Calgary, Alberta

P148 The Use of Heated Humidified High Flow Oxygen Therapy in the Palliative Setting: Developing a Practice Support Document for Use in Calgary, Alberta

Soins infirmiers en réanimation lors de l’oxygénothérapie humidifiée à haut débit

Oxygen therapy is one of the most common cares provided in the emergency and intensive care units. A new technique called humidified high-flow oxygen therapy (HHFOT) is now available in France and its use tends to become widespread. Required knowledge and advices for the practice allowing managing safely patients with HHFOT is presented. Nurses’ experience in three different intensive care units using HHFOT with the encountered difficulties is evaluated.

Heated and Humidified High-Flow Oxygen Therapy Reduces Discomfort During Hypoxemic Respiratory Failure

Non-intubated critically ill patients are often treated by high-flow oxygen for acute respiratory failure. There is no current recommendation for humidification of oxygen devices. We conducted a prospective randomized trial with a final crossover period to compare nasal airway caliber and respiratory comfort in patients with acute hypoxemic respiratory failure receiving either standard oxygen therapy with no humidification or heated and humidified high-flow oxygen therapy (HHFO₂) in a medical ICU. Nasal airway caliber was measured using acoustic rhinometry at baseline, after 4 and 24 hours (H4 and H24), and 4 hours after crossover (H28). Dryness of the nose, mouth, and throat was auto-evaluated and assessed blindly by an otorhinolaryngologist. After the crossover, the subjects were asked which system they preferred. Thirty subjects completed the protocol and were analyzed. Baseline median oxygen flow was 9 and 12 L/min in the standard and HHFO₂ groups, respectively (P = .21). Acoustic rhinometry measurements showed no difference between the 2 systems. The dryness score was significantly lower in the HHFO₂ group at H4 (2 vs 6, P = .007) and H24 (0 vs 8, P = .004). During the crossover period, dryness increased promptly after switching to standard oxygen and decreased after switching to HHFO₂ (P = .008). Sixteen subjects (53%) preferred HHFO₂ (P = .01), especially those who required the highest flow of oxygen at admission (P = .05). Upper airway caliber was not significantly modified by HHFO₂, compared to standard oxygen therapy, but HHFO₂ significantly reduced discomfort in critically ill patients with respiratory failure. The system is usually preferred over standard oxygen therapy.

High-flow humidified oxygen therapy used to alleviate respiratory distress

This article describes the utilization of humidified high-flow oxygen therapy systems, which can comfortably deliver optimal humidified high-flow oxygen therapy, via nasal cannulae, at flow rates of up to 40 litres per minute to adult patients, in hospital or at home. The oxygen is saturated with water vapour at body temperature allowing flow to be well tolerated. First, to set the scene, three clinical scenarios are presented of patients nursed in intensive care, who suffered severe respiratory distress. Respiratory failure is explained, and the need for oxygen therapy set out. Alternative oxygen delivery devices and systems are then outlined, and an example of a high-flow system introduced. Set-up of the system is explained and the need for decontamination propounded. Finally, the benefits of the humidified high-flow oxygen system are exemplified, with particular reference to the critically ill patients presented here.