High Flow Nasal Cannula Oxygen Therapy - Part 3

The article was written by Dr., Doctor Truong Ngoc Hai, Department of Emergency Resuscitation, Vinmec Central Park International General Hospital

Immunocompromised patients have an increased mortality when intubation is required. This is largely due to an increased risk of infection. The HIGH trial [13], performed in immunocompromised patients, did not show a significant reduction in 28-day mortality or intubation rates in patients with hypoxic acute respiratory failure. when comparing high-flow nasal cannula oxygen therapy with standard oxygen therapy. No significant adverse effects were noted due to high-flow nasal cannula oxygen therapy. Hui-BinHuang (2018) performed a meta-analysis showing that compared with low-flow nasogastric oxygen therapy and NIV, high-flow nasogastric oxygen therapy can significantly reduce both mortality and morbidity. rate of intubation in immunocompromised patients with acute respiratory failure.
Shortness of breath and acute hypoxemia are 2 of the most common reasons for patient admission to the emergency department. Nuttapol et al. (2015) reported a prospective randomized comparative study determining whether high-flow nasal cannula oxygen therapy is superior to conventional oxygen therapy in the emergency department. Research has found that high-flow nasal cannula oxygen therapy improves dyspnea and comfort in patients presenting to the emergency department for dyspnea and/or hypoxemia.

According to the National Center for Health Statistics (USA), in 2015 51,811 people died from pneumonia and 544,000 patients went to the emergency room, were discharged from the hospital with pneumonia. Omote et al. (2018) showed that compared with NIV, high-flow nasal cannula oxygen therapy improved 30-day survival in patients with acute respiratory failure due to interstitial pneumonia.
All patients with chronic obstructive pulmonary disease (COPD) will progress to an outcome requiring oxygen, if not death from other causes. COPD exacerbations are also a common reason for hospitalization. Many COPD patients benefit from NIV during the acute phase. However, a major limitation of NIV is the low level of compliance and patient comfort. High-flow nasal cannula oxygen therapy provides the benefits of PEEP and increases oxygen saturation similar to NIV but with increased patient comfort and compliance. In addition, Dzira et al. (2017) found that in GOLD-standardized stage III and IV COPD patients, high-flow nasal cannula oxygen therapy at airflow rates greater than 30 L per minute reduced respiratory rate, reduced inspiratory time to total cycle time and decreased diaphragmatic respiratory work compared with NIV.[14][2][15][16][17][18]

High-flow nasal cannula oxygen therapy is a relatively new treatment and not everyone is familiar with the device. Induction sessions should be held for nurses, respiratory therapists, and other physicians prior to the introduction of hospital treatments. A collaborative team of attending physicians, respiratory therapists, and critical care nurses can significantly improve patient outcomes with high-flow nasal cannula oxygen therapy. Nurses should closely monitor the patient's vitals and breathing while administering high-flow nasal oxygen therapy to ensure there is no risk of respiratory failure. The respiratory therapist adjusts the flow rate and percentage of oxygen to meet the patient's needs and reduce the risk of high oxygen levels or respiratory damage from high pressure (barotrauma). Discussing the effectiveness of high-flow nasal cannula oxygen therapy with the treating physician, or the need for higher levels of respiratory support when needed, the respiratory nurse and physician can improve outcomes. health care results by notifying the treating doctor for timely adjustment to the patient.
To avoid complications and get the best treatment effect, you should go to reputable medical facilities with a team of highly qualified doctors. Vinmec International General Hospital is a high-quality medical facility in Vietnam with a team of highly qualified medical professionals, well-trained, domestic and foreign, and experienced.
A system of modern and advanced medical equipment, possessing many of the best machines in the world, helping to detect many difficult and dangerous diseases in a short time, supporting the diagnosis and treatment of doctors the most effective. The hospital space is designed according to 5-star hotel standards, giving patients comfort, friendliness and peace of mind.

References
Summary of translations from Sharma S, Danckers M, Sanghavi D, et al. High Flow Nasal Cannula. [Updated 2020 Jul 2]. Print: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-.
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