Emergency Medical Minute27 Syys 2021

Podcast 715: Heated High Flow O2

Contributor: Nick Hatch, MD

Educational Pearls:

High flow nasal cannula (HFNC) or "heated high flow" can deliver higher oxygen levels than nasal cannula
It typically is used as an "intermediate" between oxygen via nasal cannula and other non-invasive positive pressure devices, such as BiPAP
Can modify both the FiO2 and flow rate
Maximum flow rate is typically 60 liters per minute (compare that to a typical breath that is 30-40 L/min)
Humidification of HFNC is important due to risk of epistaxis from drying out the nasal mucosa
Large energy expenditure to humidify airflow by a patient in respiratory distress, so humidified oxygen may help decrease this metabolic demand

References

Nishimura M. High-Flow Nasal Cannula Oxygen Therapy in Adults: Physiological Benefits, Indication, Clinical Benefits, and Adverse Effects. Respir Care. 2016;61(4):529-541. doi:10.4187/respcare.04577

Hacquin A, Perret M, Manckoundia P, et al. High-Flow Nasal Cannula Oxygenation in Older Patients with SARS-CoV-2-Related Acute Respiratory Failure. J Clin Med. 2021;10(16):3515. Published 2021 Aug 10. doi:10.3390/jcm10163515

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

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