Top

Published in:

01-12-2020 | Acute Respiratory Distress-Syndrome | Narrative Review

Use of nasal high flow oxygen during acute respiratory failure

Authors: Jean-Damien Ricard, Oriol Roca, Virginie Lemiale, Amanda Corley, Jens Braunlich, Peter Jones, Byung Ju Kang, François Lellouche, Stefano Nava, Nuttapol Rittayamai, Giulia Spoletini, Samir Jaber, Gonzalo Hernandez

Published in: Intensive Care Medicine | Issue 12/2020

Abstract

Nasal high flow (NHF) has gained popularity among intensivists to manage patients with acute respiratory failure. An important literature has accompanied this evolution. In this review, an international panel of experts assessed potential benefits of NHF in different areas of acute respiratory failure management. Analyses of the physiological effects of NHF indicate flow-dependent improvement in various respiratory function parameters. These beneficial effects allow some patients with severe acute hypoxemic respiratory failure to avoid intubation and improve their outcome. They require close monitoring to not delay intubation. Such a delay may worsen outcome. The ROX index may help clinicians decide when to intubate. In immunocompromised patients, NHF reduces the need for intubation but does not impact mortality. Beneficial physiological effects of NHF have also been reported in patients with chronic respiratory failure, suggesting a possible indication in acute hypercapnic respiratory failure. When intubation is required, NHF can be used to pre-oxygenate patients either alone or in combination with non-invasive ventilation (NIV). Similarly, NHF reduces reintubation alone in low-risk patients and in combination with NIV in high-risk patients. NHF may be used in the emergency department in patients who would not be offered intubation and can be better tolerated than NIV.

Available only for authorised users

Delorme M, Bouchard P-A, Simon M et al (2017) Effects of high-flow nasal cannula on the work of breathing in patients recovering from acute respiratory failure. Crit Care Med 45:1981–1988PubMed

Mauri T, Alban L, Turrini C et al (2017) Optimum support by high-flow nasal cannula in acute hypoxemic respiratory failure: effects of increasing flow rates. Intensive Care Med 43:1453–1463PubMed

Mauri T, Turrini C, Eronia N et al (2017) Physiologic effects of high-flow nasal cannula in acute hypoxemic respiratory failure. Am J Respir Crit Care Med 195:1207–1215PubMed

Bräunlich J, Köhler M, Wirtz H (2016) Nasal highflow improves ventilation in patients with COPD. Int J Chron Obstruct Pulmon Dis 11:1077–1085PubMedPubMedCentral

Corley A, Caruana LR, Barnett AG et al (2011) Oxygen delivery through high-flow nasal cannulae increase end-expiratory lung volume and reduce respiratory rate in post-cardiac surgical patients. Br J Anaesth 107:998–1004PubMed

Mauri T, Galazzi A, Binda F et al (2018) Impact of flow and temperature on patient comfort during respiratory support by high-flow nasal cannula. Crit Care 22:120PubMedPubMedCentral

Messika J, Ben Ahmed K, Gaudry S et al (2015) Use of high-flow nasal cannula oxygen therapy in subjects with ARDS: a 1-year observational study. Respir Care 60:162–169PubMed

Roca O, Pérez-Terán P, Masclans JR et al (2013) Patients with New York Heart Association class III heart failure may benefit with high flow nasal cannula supportive therapy: high flow nasal cannula in heart failure. J Crit Care 28:741–746PubMed

Roca O, de Acilu MG, Caralt B et al (2015) Humidified high flow nasal cannula supportive therapy improves outcomes in lung transplant recipients readmitted to the intensive care unit because of acute respiratory failure. Transplantation 99:1092–1098PubMed

10.

Rello J, Pérez M, Roca O et al (2012) High-flow nasal therapy in adults with severe acute respiratory infection: a cohort study in patients with 2009 influenza A/H1N1v. J Crit Care 27:434–439PubMed

11.

Sztrymf B, Messika J, Bertrand F et al (2011) Beneficial effects of humidified high flow nasal oxygen in critical care patients: a prospective pilot study. Intensive Care Med 37:1780–1786PubMed

12.

Frat JP, Thille AW, Mercat A et al (2015) High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. N Engl J Med 372(23):2185–2196PubMed

13.

Rochwerg B, Granton D, Wang DX et al (2019) High flow nasal cannula compared with conventional oxygen therapy for acute hypoxemic respiratory failure: a systematic review and meta-analysis. Intensive Care Med 45:563–572PubMed

14.

Monro-Somerville T, Sim M, Ruddy J et al (2017) The effect of high-flow nasal cannula oxygen therapy on mortality and intubation rate in acute respiratory failure: a systematic review and meta-analysis. Crit Care Med 45:e449–e456PubMed

15.

Jones PG, Kamona S, Doran O et al (2016) Randomized controlled trial of humidified high-flow nasal oxygen for acute respiratory distress in the emergency department: the HOT-ER study. Respir Care 61:291–299PubMed

16.

Makdee O, Monsomboon A, Surabenjawong U et al (2017) High-flow nasal cannula versus conventional oxygen therapy in emergency department patients with cardiogenic pulmonary edema: a randomized controlled trial. Ann Emerg Med 70:465–472.e2PubMed

17.

Bell N, Hutchinson CL, Green TC et al (2015) Randomised control trial of humidified high flow nasal cannulae versus standard oxygen in the emergency department: high flow oxygen randomised control trial. Emerg Med Australas 27:537–541PubMed

18.

Rittayamai N, Tscheikuna J, Praphruetkit N, Kijpinyochai S (2015) Use of high-flow nasal cannula for acute dyspnea and hypoxemia in the emergency department. Respir Care 60:1377–1382PubMed

19.

Tinelli V, Cabrini L, Fominskiy E et al (2019) High flow nasal cannula oxygen vs. conventional oxygen therapy and noninvasive ventilation in emergency department patients: a systematic review and meta-analysis. J Emerg Med 57:322–328PubMed

20.

Doshi P, Whittle JS, Bublewicz M et al (2018) High-velocity nasal insufflation in the treatment of respiratory failure: a randomized clinical trial. Ann Emerg Med 72:73–83.e5PubMed

21.

García-de-Acilu M, Marin-Corral J, Vázquez A et al (2017) Hypoxemic patients with bilateral infiltrates treated with high-flow nasal cannula present a similar pattern of biomarkers of inflammation and injury to acute respiratory distress syndrome patients. Crit Care Med 45:1845–1853PubMed

22.

Roca O, Messika J, Caralt B et al (2016) Predicting success of high-flow nasal cannula in pneumonia patients with hypoxemic respiratory failure: the utility of the ROX index. J Crit Care 35:200–205PubMed

23.

Roca O, Caralt B, Messika J et al (2019) An index combining respiratory rate and oxygenation to predict outcome of nasal high-flow therapy. Am J Respir Crit Care Med 199:1368–1376PubMed

24.

Bellani G, Laffey JG, Pham T et al (2017) Noninvasive ventilation of patients with acute respiratory distress syndrome. insights from the LUNG SAFE study. Am J Respir Crit Care Med 195:67–77PubMed

25.

Kang BJ, Koh Y, Lim C-M et al (2015) Failure of high-flow nasal cannula therapy may delay intubation and increase mortality. Intensive Care Med 41:623–632PubMed

26.

Nedel WL, Deutschendorf C, Moraes Rodrigues Filho E (2017) High-flow nasal cannula in critically ill subjects with or at risk for respiratory failure: a systematic review and meta-analysis. Respir Care 62:123–132PubMed

27.

Mokart D, Geay C, Chow-Chine L et al (2015) High-flow oxygen therapy in cancer patients with acute respiratory failure. Intensive Care Med 41:2008–2010PubMed

28.

Coudroy R, Jamet A, Petua P et al (2016) High-flow nasal cannula oxygen therapy versus noninvasive ventilation in immunocompromised patients with acute respiratory failure: an observational cohort study. Ann Intensive Care 6:45PubMedPubMedCentral

29.

Frat J-P, Ragot S, Girault C et al (2016) Effect of non-invasive oxygenation strategies in immunocompromised patients with severe acute respiratory failure: a post hoc analysis of a randomised trial. Lancet Respir Med 4:646–652PubMed

30.

Tu G, He H, Yin K et al (2017) High-flow nasal cannula versus noninvasive ventilation for treatment of acute hypoxemic respiratory failure in renal transplant recipients. Transpl Proc 49:1325–1330

31.

Lemiale V, Resche-Rigon M, Mokart D et al (2017) High-flow nasal cannula oxygenation in immunocompromised patients with acute hypoxemic respiratory failure: a groupe de recherche respiratoire en réanimation onco-hématologique study. Crit Care Med 45:e274–e280PubMed

32.

Azoulay E, Lemiale V, Mokart D et al (2018) Effect of high-flow nasal oxygen vs standard oxygen on 28-day mortality in immunocompromised patients with acute respiratory failure: the HIGH randomized clinical trial. JAMA 320:2099–2107PubMedPubMedCentral

33.

Dumas G, Chevret S, Lemiale V et al (2018) Oxygenation/non-invasive ventilation strategy and risk for intubation in immunocompromised patients with hypoxemic acute respiratory failure. Oncotarget 9:33682–33693PubMedPubMedCentral

34.

Azoulay E, Pickkers P, Soares M et al (2017) Acute hypoxemic respiratory failure in immunocompromised patients: the Efraim multinational prospective cohort study. Intensive Care Med 43:1808–1819PubMed

35.

Cortegiani A, Crimi C, Sanfilippo F et al (2019) High flow nasal therapy in immunocompromised patients with acute respiratory failure: a systematic review and meta-analysis. J Crit Care 50:250–256PubMed

36.

Wang Y, Ni Y, Sun J, Liang Z (2020) Use of high-flow nasal cannula for immunocompromise and acute respiratory failure: a systematic review and meta-analysis. J Emerg Med 58:413–423PubMed

37.

Pisani L, Vega ML (2017) Use of nasal high flow in stable COPD: rationale and physiology. COPD J Chron Obstruct Pulmon Dis 14:346–350

38.

Ritchie JE, Williams AB, Gerard C, Hockey H (2011) Evaluation of a humidified nasal high-flow oxygen system, using oxygraphy, capnography and measurement of upper airway pressures. Anaesth Intensive Care 39:1103–1110PubMed

39.

Bräunlich J, Beyer D, Mai D et al (2013) Effects of nasal high flow on ventilation in volunteers, COPD and idiopathic pulmonary fibrosis patients. Respiration 85:319–325PubMed

40.

Biselli P, Fricke K, Grote L et al (2018) Reductions in dead space ventilation with nasal high flow depend on physiological dead space volume: metabolic hood measurements during sleep in patients with COPD and controls. Eur Respir J 51:1702251PubMed

41.

Fraser JF, Spooner AJ, Dunster KR et al (2016) Nasal high flow oxygen therapy in patients with COPD reduces respiratory rate and tissue carbon dioxide while increasing tidal and end-expiratory lung volumes: a randomised crossover trial. Thorax 71:759–761PubMedPubMedCentral

42.

Pisani L, Fasano L, Corcione N et al (2017) Change in pulmonary mechanics and the effect on breathing pattern of high flow oxygen therapy in stable hypercapnic COPD. Thorax 72:373–375PubMed

43.

Longhini F, Pisani L, Lungu R et al (2019) High-flow oxygen therapy after noninvasive ventilation interruption in patients recovering from hypercapnic acute respiratory failure: a physiological crossover trial. Crit Care Med 47:e506–e511PubMed

44.

Bräunlich J, Mauersberger F, Wirtz H (2018) Effectiveness of nasal highflow in hypercapnic COPD patients is flow and leakage dependent. BMC Pulm Med 18:14PubMedPubMedCentral

45.

Möller W, Feng S, Domanski U et al (2017) Nasal high flow reduces dead space. J Appl Physiol 122:191–197PubMed

46.

Bräunlich J, Dellweg D, Bastian A et al (2019) Nasal high-flow versus noninvasive ventilation in patients with chronic hypercapnic COPD. COPD 14:1411–1421

47.

Pisani L, Betti S, Biglia C et al (2020) Effects of high-flow nasal cannula in patients with persistent hypercapnia after an acute COPD exacerbation: a prospective pilot study. BMC Pulm Med 20:12PubMedPubMedCentral

48.

Rochwerg B, Brochard L, Elliott MW et al (2017) Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J 50:1602426PubMed

49.

Spoletini G, Mega C, Pisani L et al (2018) High-flow nasal therapy vs standard oxygen during breaks off noninvasive ventilation for acute respiratory failure: a pilot randomized controlled trial. J Crit Care 48:418–425PubMed

50.

Lee MK, Choi J, Park B et al (2018) High flow nasal cannulae oxygen therapy in acute-moderate hypercapnic respiratory failure. Clin Respir J 12:2046–2056PubMed

51.

Pilcher J, Eastlake L, Richards M et al (2017) Physiological effects of titrated oxygen via nasal high-flow cannulae in COPD exacerbations: a randomized controlled cross-over trial. Respirology 22:1149–1155PubMed

52.

Ricard J-D, Dib F, Esposito-Farese M et al (2018) Comparison of high flow nasal cannula oxygen and conventional oxygen therapy on ventilatory support duration during acute-on-chronic respiratory failure: study protocol of a multicentre, randomised, controlled trial. The “HIGH-FLOW ACRF” study. BMJ Open 8:e022983PubMedPubMedCentral

53.

Cortegiani A, Longhini F, Carlucci A et al (2019) High-flow nasal therapy versus noninvasive ventilation in COPD patients with mild-to-moderate hypercapnic acute respiratory failure: study protocol for a noninferiority randomized clinical trial. Trials 20:450PubMedPubMedCentral

54.

Ricard JD, Gaborieau B, Bernier J et al (2019) Use of high flow nasal cannula for preoxygenation and apneic oxygenation during intubation. Ann Transl Med 7:S380PubMedPubMedCentral

55.

Ricard JD (2016) Hazards of intubation in the ICU: role of nasal high flow oxygen therapy for preoxygenation and apneic oxygenation to prevent desaturation. Minerva Anestesiol 82:1098–1106PubMed

56.

Baillard C, Fosse J-P, Sebbane M et al (2006) Noninvasive ventilation improves preoxygenation before intubation of hypoxic patients. Am J Respir Crit Care Med 174:171–177PubMed

57.

Baillard C, Prat G, Jung B et al (2018) Effect of preoxygenation using non-invasive ventilation before intubation on subsequent organ failures in hypoxaemic patients: a randomised clinical trial. Br J Anaesth 120:361–367PubMed

58.

Papazian L, Corley A, Hess D et al (2016) Use of high-flow nasal cannula oxygenation in ICU adults: a narrative review. Intensive Care Med 42:1336–1349PubMed

59.

Miguel-Montanes R, Hajage D, Messika J et al (2015) Use of high-flow nasal cannula oxygen therapy to prevent desaturation during tracheal intubation of intensive care patients with mild-to-moderate hypoxemia. Crit Care Med 43:574–583PubMed

60.

Guitton C, Ehrmann S, Volteau C et al (2019) Nasal high-flow preoxygenation for endotracheal intubation in the critically ill patient: a randomized clinical trial. Intensive Care Med 45:447–458PubMed

61.

Vourc’hVourc’h M, Asfar P, Volteau C et al (2015) High-flow nasal cannula oxygen during endotracheal intubation in hypoxemic patients: a randomized controlled clinical trial. Intensive Care Med 41:1538–1548

62.

Simon M, Wachs C, Braune S et al (2016) High-flow nasal cannula versus bag-valve-mask for preoxygenation before intubation in subjects with hypoxemic respiratory failure. Respir Care 61:1160–1167PubMed

63.

De Jong A, Jaber S (2016) Apneic oxygenation for intubation in the critically ill. Let’s not give up! Am J Respir Crit Care Med 193:230–232PubMed

64.

Frat J-P, Ricard J-D, Quenot J-P et al (2019) Non-invasive ventilation versus high-flow nasal cannula oxygen therapy with apnoeic oxygenation for preoxygenation before intubation of patients with acute hypoxaemic respiratory failure: a randomised, multicentre, open-label trial. Lancet Respir Med 7:303–312PubMed

65.

Jaber S, Monnin M, Girard M et al (2016) Apnoeic oxygenation via high-flow nasal cannula oxygen combined with non-invasive ventilation preoxygenation for intubation in hypoxaemic patients in the intensive care unit: the single-centre, blinded, randomised controlled OPTINIV trial. Intensive Care Med 42:1877–1887PubMed

66.

Esteban A, Frutos-Vivar F, Ferguson ND et al (2004) Noninvasive positive-pressure ventilation for respiratory failure after extubation. N Engl J Med 350:2452–2460PubMed

67.

Canet J, Gallart L, Gomar C et al (2010) Prediction of postoperative pulmonary complications in a population-based surgical cohort. Anesthesiology 113:1338–1350PubMed

68.

Stéphan F, Barrucand B, Petit P et al (2015) High-flow nasal oxygen vs noninvasive positive airway pressure in hypoxemic patients after cardiothoracic surgery: a randomized clinical trial. JAMA 313:2331–2339PubMed

69.

Futier E, Paugam-Burtz C, Godet T et al (2016) Effect of early postextubation high-flow nasal cannula vs conventional oxygen therapy on hypoxaemia in patients after major abdominal surgery: a French multicentre randomised controlled trial (OPERA). Intensive Care Med 42:1888–1898PubMed

70.

Thille AW, Boissier F, Ben Ghezala H et al (2015) Risk factors for and prediction by caregivers of extubation failure in ICU patients: a prospective study. Crit Care Med 43:613–620PubMed

71.

Ferrer M, Valencia M, Nicolas JM et al (2006) Early noninvasive ventilation averts extubation failure in patients at risk: a randomized trial. Am J Respir Crit Care Med 173:164–170PubMed

72.

Hernández G, Vaquero C, Colinas L et al (2016) Effect of postextubation high-flow nasal cannula vs noninvasive ventilation on reintubation and postextubation respiratory failure in high-risk patients: a randomized clinical trial. JAMA 316:1565–1574PubMed

73.

Salam A, Tilluckdharry L, Amoateng-Adjepong Y, Manthous CA (2004) Neurologic status, cough, secretions and extubation outcomes. Intensive Care Med 30:1334–1339PubMed

74.

Hernández G, Vaquero C, González P et al (2016) Effect of postextubation high-flow nasal cannula vs conventional oxygen therapy on reintubation in low-risk patients: a randomized clinical trial. JAMA 315:1354–1361PubMed

75.

Zhu Y, Yin H, Zhang R et al (2019) High-flow nasal cannula oxygen therapy versus conventional oxygen therapy in patients after planned extubation: a systematic review and meta-analysis. Crit Care 23:180PubMedPubMedCentral

76.

Thille AW, Muller G, Gacouin A et al (2019) Effect of postextubation high-flow nasal oxygen with noninvasive ventilation vs high-flow nasal oxygen alone on reintubation among patients at high risk of extubation failure: a randomized clinical trial. JAMA 322:1465–1475PubMedPubMedCentral

77.

Ruangsomboon O, Dorongthom T, Chakorn T et al (2020) High-flow nasal cannula versus conventional oxygen therapy in relieving dyspnea in emergency palliative patients with do-not-intubate status: a randomized crossover study. Ann Emerg Med 75:615–626PubMed

78.

Epstein AS, Hartridge-Lambert SK, Ramaker JS et al (2011) Humidified high-flow nasal oxygen utilization in patients with cancer at Memorial Sloan-Kettering Cancer Center. J Palliat Med 14:835–839PubMedPubMedCentral

79.

Peters SG, Holets SR, Gay PC (2013) Nasal high flow oxygen therapy in do-not-intubate patients with hypoxemic respiratory distress. Respir Care 58:597–600PubMed

80.

Koyauchi T, Hasegawa H, Kanata K et al (2018) Efficacy and tolerability of high-flow nasal cannula oxygen therapy for hypoxemic respiratory failure in patients with interstitial lung disease with do-not-intubate orders: a retrospective single-center study. Respiration 96:323–329PubMed

81.

Zemach S, Helviz Y, Shitrit M et al (2019) The use of high-flow nasal cannula oxygen outside the ICU. Respir Care 64:1333–1342PubMed

82.

Hui D, Morgado M, Chisholm G et al (2013) High-flow oxygen and bilevel positive airway pressure for persistent dyspnea in patients with advanced cancer: a phase II randomized trial. J Pain Symptom Manage 46:463–473PubMedPubMedCentral

Title: Use of nasal high flow oxygen during acute respiratory failure
Authors: Jean-Damien Ricard
Oriol Roca
Virginie Lemiale
Amanda Corley
Jens Braunlich
Peter Jones
Byung Ju Kang
François Lellouche
Stefano Nava
Nuttapol Rittayamai
Giulia Spoletini
Samir Jaber
Gonzalo Hernandez
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keywords: Acute Respiratory Distress-Syndrome
Non-Invasive Ventilation
Published in: Intensive Care Medicine / Issue 12/2020
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-020-06228-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Use of nasal high flow oxygen during acute respiratory failure

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 12/2020

Prone position in ARDS patients: why, when, how and for whom

Myorelaxants in ARDS patients

What’s new about pulmonary hyperinflation in mechanically ventilated critical patients

Emerging pharmacological therapies for ARDS: COVID-19 and beyond

Proportional modes of ventilation: technology to assist physiology

Acute respiratory failure and mechanical ventilation in the context of the COVID-19 pandemic: why a special issue in ICM?