Factors influencing nasal airway pressure and comfort in high-flow nasal cannula oxygen therapy: a volunteer study

Abstract Background High-flow nasal cannula (HFNC) oxygen therapy is essentially a constant-flow, noninvasive respiratory support system similar to a noninvasive ventilator operating in constant-flow mode. The clinical outcome of HFNC oxygen therapy is strongly associated with the pressure generated...

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Main Authors: Enqi Zhao, Yilong Zhou, Chunwei He, Dedong Ma
Format: Article
Language:English
Published: BMC 2023-11-01
Series:BMC Pulmonary Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12890-023-02752-6
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author Enqi Zhao
Yilong Zhou
Chunwei He
Dedong Ma
author_facet Enqi Zhao
Yilong Zhou
Chunwei He
Dedong Ma
author_sort Enqi Zhao
collection DOAJ
description Abstract Background High-flow nasal cannula (HFNC) oxygen therapy is essentially a constant-flow, noninvasive respiratory support system similar to a noninvasive ventilator operating in constant-flow mode. The clinical outcome of HFNC oxygen therapy is strongly associated with the pressure generated by high-flow gas and the patient’s comfort level. This study was performed to explore the relevant factors affecting pressure and comfort of HFNC oxygen therapy in vivo. Methods Thirty-five healthy volunteers were enrolled in the trial. They underwent placement of nasal cannulas of various inner diameters (3, 4 or 5 mm) and treatment with different HFNC devices [HFT-300 (Weishengkang Medical Technology Co., Ltd., Jiangsu China) or H-80 M (BMC Medical Co., Ltd., Beijing China)],and the nasal airway pressure and comfort were assessed. Multiple linear regression was used to determine predictors of airway pressure. Results Multiple linear regression showed that the end-expiratory pressure was associated with the flow rate, sex, height, and cannula size. The end-expiratory pressure increased by 0.6 cmH2O per 1-mm increase in cannula diameter, decreased by 0.3 cmH2O per 10-cm increase in participant height (with a 0.35 cmH2O decrease for men), and increased by 1 cmH2O when the flow rate increased by 10 L/min (R2 = 0.75, P < 0.05 for all variables in model). In addition, the pressure generated by the H-80 M device was higher than that generated by the HFT-300 device (P < 0.05). Discomfort manifested as difficulty in expiration, and its severity increased as the cannula diameter increased; however there was no significant difference in comfort between the two HFNC devices (P > 0.05). Conclusion In volunteers undergoing HFNC oxygen therapy, the nasal cannula diameter, flow rate, sex, height, and device model can affect the nasal airway pressure, and the nasal catheter diameter and flow rate can affect comfort. These factors should be given close attention in clinical practice. Trial registration ChiCTR2300068313 (date of first registration: 14 February 2023,  https://www.chictr.org.cn ).
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spelling doaj.art-078e2f6085f144088e3f41ccf54bdc652023-11-26T12:13:15ZengBMCBMC Pulmonary Medicine1471-24662023-11-0123111010.1186/s12890-023-02752-6Factors influencing nasal airway pressure and comfort in high-flow nasal cannula oxygen therapy: a volunteer studyEnqi Zhao0Yilong Zhou1Chunwei He2Dedong Ma3Qilu Hospital of Shandong UniversityQilu Hospital of Shandong UniversityQilu Hospital of Shandong UniversityDepartment of Respiratory and Critical Care Medicine, Qilu Hospital of Shandong UniversityAbstract Background High-flow nasal cannula (HFNC) oxygen therapy is essentially a constant-flow, noninvasive respiratory support system similar to a noninvasive ventilator operating in constant-flow mode. The clinical outcome of HFNC oxygen therapy is strongly associated with the pressure generated by high-flow gas and the patient’s comfort level. This study was performed to explore the relevant factors affecting pressure and comfort of HFNC oxygen therapy in vivo. Methods Thirty-five healthy volunteers were enrolled in the trial. They underwent placement of nasal cannulas of various inner diameters (3, 4 or 5 mm) and treatment with different HFNC devices [HFT-300 (Weishengkang Medical Technology Co., Ltd., Jiangsu China) or H-80 M (BMC Medical Co., Ltd., Beijing China)],and the nasal airway pressure and comfort were assessed. Multiple linear regression was used to determine predictors of airway pressure. Results Multiple linear regression showed that the end-expiratory pressure was associated with the flow rate, sex, height, and cannula size. The end-expiratory pressure increased by 0.6 cmH2O per 1-mm increase in cannula diameter, decreased by 0.3 cmH2O per 10-cm increase in participant height (with a 0.35 cmH2O decrease for men), and increased by 1 cmH2O when the flow rate increased by 10 L/min (R2 = 0.75, P < 0.05 for all variables in model). In addition, the pressure generated by the H-80 M device was higher than that generated by the HFT-300 device (P < 0.05). Discomfort manifested as difficulty in expiration, and its severity increased as the cannula diameter increased; however there was no significant difference in comfort between the two HFNC devices (P > 0.05). Conclusion In volunteers undergoing HFNC oxygen therapy, the nasal cannula diameter, flow rate, sex, height, and device model can affect the nasal airway pressure, and the nasal catheter diameter and flow rate can affect comfort. These factors should be given close attention in clinical practice. Trial registration ChiCTR2300068313 (date of first registration: 14 February 2023,  https://www.chictr.org.cn ).https://doi.org/10.1186/s12890-023-02752-6End-expiratory pressureComfortInfluencing factorHigh-flow nasal cannula
spellingShingle Enqi Zhao
Yilong Zhou
Chunwei He
Dedong Ma
Factors influencing nasal airway pressure and comfort in high-flow nasal cannula oxygen therapy: a volunteer study
BMC Pulmonary Medicine
End-expiratory pressure
Comfort
Influencing factor
High-flow nasal cannula
title Factors influencing nasal airway pressure and comfort in high-flow nasal cannula oxygen therapy: a volunteer study
title_full Factors influencing nasal airway pressure and comfort in high-flow nasal cannula oxygen therapy: a volunteer study
title_fullStr Factors influencing nasal airway pressure and comfort in high-flow nasal cannula oxygen therapy: a volunteer study
title_full_unstemmed Factors influencing nasal airway pressure and comfort in high-flow nasal cannula oxygen therapy: a volunteer study
title_short Factors influencing nasal airway pressure and comfort in high-flow nasal cannula oxygen therapy: a volunteer study
title_sort factors influencing nasal airway pressure and comfort in high flow nasal cannula oxygen therapy a volunteer study
topic End-expiratory pressure
Comfort
Influencing factor
High-flow nasal cannula
url https://doi.org/10.1186/s12890-023-02752-6
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AT chunweihe factorsinfluencingnasalairwaypressureandcomfortinhighflownasalcannulaoxygentherapyavolunteerstudy
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