Title: High Flow Nasal Cannula <br/>Author: Feras Khan<br/><a href='http://umem.org/profiles/faculty/1145/'>[Click to email author]</a><hr/><p>
<strong>High Flow Nasal Cannula</strong></p>
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<em>What is it?</em></p>
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High flow nasal cannula has been used in pediatrics for some time now</li>
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It can be used in adults as well</li>
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It is a simple nasal cannula setup with larger cannula sizes in both nares</li>
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It is heated, humidified oxygen</li>
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You can control your oxygen level and flow of oxygen</li>
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<em>Benefits</em></p>
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Small amount of PEEP provided to the patient (estimated 5-7 cm H20)</li>
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Improves oxygenation (more reliable oxygenation than a non-rebreather face mask)</li>
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Can provide some alveolar recruitment</li>
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Increases FRC (functional residual capacity)</li>
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Pharyngeal dead space washout</li>
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<em>Who to use it on</em></p>
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Acute hypoxemic respiratory failure</li>
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Pre-intubation (can place before and during intubation in patients who have low oxygen saturation)</li>
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Post-extubation</li>
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Palliative care (DNI patients)</li>
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<em>How to set it</em></p>
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Flow rates: 0-60 L/min</li>
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Spontaneously breathing patient with mild-moderate hypoxemia/respiratory distress:</li>
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-15-30 L per minute</p>
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-100% oxygen (wean as tolerated)</p>
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-temp 35-40 C</p>
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-when weaning decrease oxygen prior to flow</p>
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<strong>Bottom line:</strong> <u>No evidence</u> that it reduces intubation rates in patients with hypoxemic respiratory failure but may improve oxygenation issues while deciding on treatment options</p>
<fieldset><legend>References</legend>
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<span style="font-size: 16.000000pt; font-family: 'TrebuchetMS'; font-weight: 700">Clinical evidence on high flow oxygen therapy and active humidification in adults </span></p>
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<span style="font-size: 12.000000pt; font-family: 'TrebuchetMS'; font-weight: 700">C. Gotera</span><span style="font-size: 8.000000pt; font-family: 'TrebuchetMS'; font-weight: 700; color: rgb(0.000000%, 50.200000%, 67.500000%); vertical-align: 4.000000pt">a</span><span style="font-size: 12.000000pt; font-family: 'TrebuchetMS'; font-weight: 700">, S. Díaz Lobato</span><span style="font-size: 8.000000pt; font-family: 'TrebuchetMS'; font-weight: 700; color: rgb(0.000000%, 50.200000%, 67.500000%); vertical-align: 4.000000pt">a</span><span style="font-size: 8.000000pt; font-family: 'NmtmibA'; vertical-align: 4.000000pt">,</span><span style="font-size: 8.000000pt; font-family: 'MTSYB'; color: rgb(0.000000%, 50.200000%, 67.500000%); vertical-align: 4.000000pt">∗</span><span style="font-size: 12.000000pt; font-family: 'TrebuchetMS'; font-weight: 700">, T. Pinto</span><span style="font-size: 8.000000pt; font-family: 'TrebuchetMS'; font-weight: 700; color: rgb(0.000000%, 50.200000%, 67.500000%); vertical-align: 4.000000pt">b</span><span style="font-size: 12.000000pt; font-family: 'TrebuchetMS'; font-weight: 700">, J.C. Winck</span><span style="font-size: 8.000000pt; font-family: 'TrebuchetMS'; font-weight: 700; color: rgb(0.000000%, 50.200000%, 67.500000%); vertical-align: 4.000000pt">b</span></p>
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<span style="font-size: 8.000000pt; font-family: 'TrebuchetMS'; font-weight: 700; color: rgb(0.000000%, 50.200000%, 67.500000%); vertical-align: 4.000000pt">March 2013, Portugese Journal of Pulmonology</span></p>
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