scholarly journals High-Efficiency Generation and Delivery of Aerosols Through Nasal Cannula During Noninvasive Ventilation

2013 ◽  
Vol 26 (5) ◽  
pp. 266-279 ◽  
Author(s):  
P. Worth Longest ◽  
Ross L. Walenga ◽  
Yoen-Ju Son ◽  
Michael Hindle
Keyword(s):  
Noninvasive Ventilation ◽  
High Efficiency ◽  
Nasal Cannula

Readiness Assessment for Extubation Planning in the Intensive Care Unit: A Quality Improvement Initiative

2021 ◽  
Vol 41 (3) ◽  
pp. 42-48
Author(s):  
Jace D. Johnny
Keyword(s):  
High Risk ◽  
Failure Rate ◽  
Noninvasive Ventilation ◽  
Extubation Failure ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Prophylactic Measure ◽  
High Risk Patients ◽  
Risk Patients

Background Extubation failure is the reintubation of patients meeting criteria for weaning from mechanical ventilation. Extubation failure is correlated with mortality, prolonged mechanical ventilation, and longer hospital stays. Noninvasive ventilation or high-flow nasal cannula oxygen therapy after extubation is recommended to prevent extubation failure in high-risk patients. Local Problem The extubation failure rate is unknown. Prophylactic measures (noninvasive ventilation or high-flow nasal cannula) after extubation are not commonly used and vary among clinicians. The objective was to assess extubation planning readiness by determining extubation failure rate, identifying high-risk patients, and determining prophylactic measure compliance. Methods A quality improvement initiative included an evidence-based extubation failure risk assessment that identified high-risk patients and determined prophylactic measure compliance. A 2-year retrospective medical record review was used to determine baseline patient characteristics and extubation failure rate. Results Extubation failure rate within the retrospective cohort was 13 of 146 patients (8.9%). Extubation failure did not correlate with previously identified risk factors; however, 150 identified patients were excluded from analysis. During risk assessment integration, the extubation failure rate was 3 of 37 patients (8.1%) despite identifying 24 high-risk patients (65%). Few high-risk patients received prophylactic measures (noninvasive ventilation, 17%; high-flow nasal cannula, 12%). Conclusions Extubation failure should be routinely measured because of its effects on patient outcomes. This project reveals the multifactorial nature of extubation failure. Further research is needed to assess patients’ risk and account for acute conditions. This project used best practice guidelines for routine patient care and added transparency to a previously unmeasured event.

High-Flow Nasal Cannula Versus Noninvasive Ventilation

2019 ◽  
Vol 20 (12) ◽  
pp. 1210-1211 ◽  
Author(s):  
Vicent Modesto i Alapont ◽  
Martí Pons-Òdena ◽  
Alberto Medina
Keyword(s):  
Noninvasive Ventilation ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula

Is high-flow nasal cannula oxygenation more effective than noninvasive ventilation or conventional oxygen therapy in treating acute hypoxemic respiratory failure in COVID-19 patients?

2020 ◽  
Vol 54 ◽  
Author(s):  
Cary Amiel G. Villanueva ◽  
Marie Gene D. Cruz ◽  
Lia M. Palileo-Villanueva
Keyword(s):  
Respiratory Failure ◽  
Noninvasive Ventilation ◽  
Observational Studies ◽  
Oxygen Therapy ◽  
High Flow ◽  
Nasal Cannula ◽  
Respiratory Support ◽  
High Flow Nasal Cannula ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure

KEY FINDINGSVery low-quality evidence suggests lower mortality (based on five observational studies) but higher failurerate of respiratory support (based on two observational studies) in COVID-19 patients given high-flow nasalcannula (HFNC) oxygen compared with noninvasive ventilation (NIV) and conventional oxygenation therapy.Randomized controlled trials (RCT) are urgently needed in this area.• Respiratory failure accounts for about half of deaths in patients with COVID-19.• High-flow nasal cannula (HFNC) oxygen therapy reduces the need for escalating respiratory support and improvespatient comfort compared with conventional oxygen therapy among those with acute respiratory failure.• Mortality was consistently lower in COVID-19 patients who received HFNC rather than NIV or conventionaloxygen therapy (COT) across 5 very low-quality retrospective observational studies from China.• Several international guidelines recommend the use of HFNC oxygen therapy in COVID-19 patients whodevelop acute hypoxemic respiratory failure. However, local guidelines from the Philippine Society forMicrobiology and Infectious Diseases (PSMID) and the Philippine College of Chest Physicians (PCCP) recommendagainst HFNC due to risks of transmission and paucity of direct evidence for efficacy.• Additional infection control precautions, i.e. wearing a surgical mask over the cannula, and locating in a negativepressure room, are recommended whenever using HFNC or NIV.• There are at least two ongoing trials due to be completed by the second quarter of 2021 comparingHFNC oxygenation with NIV or COT in COVID-19 patients.

scholarly journals Effect of Postextubation High-Flow Nasal Cannula vs Noninvasive Ventilation on Reintubation and Postextubation Respiratory Failure in High-Risk Patients

JAMA ◽  
2016 ◽  
Vol 316 (15) ◽  
pp. 1565 ◽  
Author(s):  
Gonzalo Hernández ◽  
Concepción Vaquero ◽  
Laura Colinas ◽  
Rafael Cuena ◽  
Paloma González ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
High Risk ◽  
Noninvasive Ventilation ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
High Risk Patients ◽  
Risk Patients
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