High-flow nasal oxygen in acute hypoxemic respiratory failure: A narrative review of the evidence before and after the COVID-19 pandemic
High-flow nasal oxygen (HFNO) is a type of non-invasive advanced respiratory support that allows the delivery of high-flow and humidified air through a nasal cannula. It can deliver a higher inspired oxygen fraction than conventional oxygen therapy (COT), improves secretion clearance, has a small po...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.1068327/full |
| _version_ | 1811216753832755200 |
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| author | Léon Genecand Léon Genecand Thomas Agoritsas Thomas Agoritsas Thomas Agoritsas Charlotte Ehrensperger Charlotte Ehrensperger Aileen Kharat Aileen Kharat Christophe Marti Christophe Marti |
| author_facet | Léon Genecand Léon Genecand Thomas Agoritsas Thomas Agoritsas Thomas Agoritsas Charlotte Ehrensperger Charlotte Ehrensperger Aileen Kharat Aileen Kharat Christophe Marti Christophe Marti |
| author_sort | Léon Genecand |
| collection | DOAJ |
| description | High-flow nasal oxygen (HFNO) is a type of non-invasive advanced respiratory support that allows the delivery of high-flow and humidified air through a nasal cannula. It can deliver a higher inspired oxygen fraction than conventional oxygen therapy (COT), improves secretion clearance, has a small positive end-expiratory pressure, and exhibits a washout effect on the upper air space that diminishes dead space ventilation. HFNO has been shown to reduce the work of breathing in acute hypoxemic respiratory failure (AHRF) and has become an interesting option for non-invasive respiratory support. Evidence published before the COVID-19 pandemic suggested a possible reduction of the need for invasive mechanical ventilation compared to COT. The COVID-19 pandemic has resulted in a substantial increase in AHRF worldwide, overwhelming both acute and intensive care unit capacity in most countries. This triggered new trials, adding to the body of evidence on HFNO in AHRF and its possible benefits compared to COT or non-invasive ventilation. We have summarized and discussed this recent evidence to inform the best supportive strategy in AHRF both related and unrelated to COVID-19. |
| first_indexed | 2024-04-12T06:43:38Z |
| format | Article |
| id | doaj.art-526a3afed9044e2eac53dd0c86ba658f |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-12T06:43:38Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-526a3afed9044e2eac53dd0c86ba658f2022-12-22T03:43:39ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-11-01910.3389/fmed.2022.10683271068327High-flow nasal oxygen in acute hypoxemic respiratory failure: A narrative review of the evidence before and after the COVID-19 pandemicLéon Genecand0Léon Genecand1Thomas Agoritsas2Thomas Agoritsas3Thomas Agoritsas4Charlotte Ehrensperger5Charlotte Ehrensperger6Aileen Kharat7Aileen Kharat8Christophe Marti9Christophe Marti10Division of General Internal Medicine, Geneva University Hospitals, Geneva, SwitzerlandFaculty of Medicine, University of Geneva, Geneva, SwitzerlandDivision of General Internal Medicine, Geneva University Hospitals, Geneva, SwitzerlandFaculty of Medicine, University of Geneva, Geneva, SwitzerlandDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, CanadaDivision of General Internal Medicine, Geneva University Hospitals, Geneva, SwitzerlandFaculty of Medicine, University of Geneva, Geneva, SwitzerlandFaculty of Medicine, University of Geneva, Geneva, SwitzerlandDivision of Pulmonary Medicine, Geneva University Hospitals, Geneva, SwitzerlandDivision of General Internal Medicine, Geneva University Hospitals, Geneva, SwitzerlandFaculty of Medicine, University of Geneva, Geneva, SwitzerlandHigh-flow nasal oxygen (HFNO) is a type of non-invasive advanced respiratory support that allows the delivery of high-flow and humidified air through a nasal cannula. It can deliver a higher inspired oxygen fraction than conventional oxygen therapy (COT), improves secretion clearance, has a small positive end-expiratory pressure, and exhibits a washout effect on the upper air space that diminishes dead space ventilation. HFNO has been shown to reduce the work of breathing in acute hypoxemic respiratory failure (AHRF) and has become an interesting option for non-invasive respiratory support. Evidence published before the COVID-19 pandemic suggested a possible reduction of the need for invasive mechanical ventilation compared to COT. The COVID-19 pandemic has resulted in a substantial increase in AHRF worldwide, overwhelming both acute and intensive care unit capacity in most countries. This triggered new trials, adding to the body of evidence on HFNO in AHRF and its possible benefits compared to COT or non-invasive ventilation. We have summarized and discussed this recent evidence to inform the best supportive strategy in AHRF both related and unrelated to COVID-19.https://www.frontiersin.org/articles/10.3389/fmed.2022.1068327/fullhigh flow nasal oxygennon-invasive ventilationcontinuous positive air pressurebi-level airway pressureacute hypoxemic respiratory failureCOVID-19 |
| spellingShingle | Léon Genecand Léon Genecand Thomas Agoritsas Thomas Agoritsas Thomas Agoritsas Charlotte Ehrensperger Charlotte Ehrensperger Aileen Kharat Aileen Kharat Christophe Marti Christophe Marti High-flow nasal oxygen in acute hypoxemic respiratory failure: A narrative review of the evidence before and after the COVID-19 pandemic Frontiers in Medicine high flow nasal oxygen non-invasive ventilation continuous positive air pressure bi-level airway pressure acute hypoxemic respiratory failure COVID-19 |
| title | High-flow nasal oxygen in acute hypoxemic respiratory failure: A narrative review of the evidence before and after the COVID-19 pandemic |
| title_full | High-flow nasal oxygen in acute hypoxemic respiratory failure: A narrative review of the evidence before and after the COVID-19 pandemic |
| title_fullStr | High-flow nasal oxygen in acute hypoxemic respiratory failure: A narrative review of the evidence before and after the COVID-19 pandemic |
| title_full_unstemmed | High-flow nasal oxygen in acute hypoxemic respiratory failure: A narrative review of the evidence before and after the COVID-19 pandemic |
| title_short | High-flow nasal oxygen in acute hypoxemic respiratory failure: A narrative review of the evidence before and after the COVID-19 pandemic |
| title_sort | high flow nasal oxygen in acute hypoxemic respiratory failure a narrative review of the evidence before and after the covid 19 pandemic |
| topic | high flow nasal oxygen non-invasive ventilation continuous positive air pressure bi-level airway pressure acute hypoxemic respiratory failure COVID-19 |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.1068327/full |
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