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Intensive Care Medicine
Published in: Intensive Care Medicine 12/2020

01-12-2020 | Conference Reports and Expert Panel

The role for high flow nasal cannula as a respiratory support strategy in adults: a clinical practice guideline

Authors: Bram Rochwerg, Sharon Einav, Dipayan Chaudhuri, Jordi Mancebo, Tommaso Mauri, Yigal Helviz, Ewan C. Goligher, Samir Jaber, Jean-Damien Ricard, Nuttapol Rittayamai, Oriol Roca, Massimo Antonelli, Salvatore Maurizio Maggiore, Alexandre Demoule, Carol L. Hodgson, Alain Mercat, M. Elizabeth Wilcox, David Granton, Dominic Wang, Elie Azoulay, Lamia Ouanes-Besbes, Gilda Cinnella, Michela Rauseo, Carlos Carvalho, Armand Dessap-Mekontso, John Fraser, Jean-Pierre Frat, Charles Gomersall, Giacomo Grasselli, Gonzalo Hernandez, Sameer Jog, Antonio Pesenti, Elisabeth D. Riviello, Arthur S. Slutsky, Renee D. Stapleton, Daniel Talmor, Arnaud W. Thille, Laurent Brochard, Karen E. A. Burns

Published in: Intensive Care Medicine | Issue 12/2020

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Abstract

Purpose

High flow nasal cannula (HFNC) is a relatively recent respiratory support technique which delivers high flow, heated and humidified controlled concentration of oxygen via the nasal route. Recently, its use has increased for a variety of clinical indications. To guide clinical practice, we developed evidence-based recommendations regarding use of HFNC in various clinical settings.

Methods

We formed a guideline panel composed of clinicians, methodologists and experts in respiratory medicine. Using GRADE, the panel developed recommendations for four actionable questions.

Results

The guideline panel made a strong recommendation for HFNC in hypoxemic respiratory failure compared to conventional oxygen therapy (COT) (moderate certainty), a conditional recommendation for HFNC following extubation (moderate certainty), no recommendation regarding HFNC in the peri-intubation period (moderate certainty), and a conditional recommendation for postoperative HFNC in high risk and/or obese patients following cardiac or thoracic surgery (moderate certainty).

Conclusions

This clinical practice guideline synthesizes current best-evidence into four recommendations for HFNC use in patients with hypoxemic respiratory failure, following extubation, in the peri-intubation period, and postoperatively for bedside clinicians.
Appendix
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Metadata
Title
The role for high flow nasal cannula as a respiratory support strategy in adults: a clinical practice guideline
Authors
Bram Rochwerg
Sharon Einav
Dipayan Chaudhuri
Jordi Mancebo
Tommaso Mauri
Yigal Helviz
Ewan C. Goligher
Samir Jaber
Jean-Damien Ricard
Nuttapol Rittayamai
Oriol Roca
Massimo Antonelli
Salvatore Maurizio Maggiore
Alexandre Demoule
Carol L. Hodgson
Alain Mercat
M. Elizabeth Wilcox
David Granton
Dominic Wang
Elie Azoulay
Lamia Ouanes-Besbes
Gilda Cinnella
Michela Rauseo
Carlos Carvalho
Armand Dessap-Mekontso
John Fraser
Jean-Pierre Frat
Charles Gomersall
Giacomo Grasselli
Gonzalo Hernandez
Sameer Jog
Antonio Pesenti
Elisabeth D. Riviello
Arthur S. Slutsky
Renee D. Stapleton
Daniel Talmor
Arnaud W. Thille
Laurent Brochard
Karen E. A. Burns
Publication date
01-12-2020
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 12/2020
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-020-06312-y

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