scholarly journals High-Flow Nasal Cannula Oxygen in Patients with Acute Respiratory Failure and Do-Not-Intubate or Do-Not-Resuscitate Orders: A Systematic Review

2019 ◽  
pp. 101-106
Author(s):  
Michael E Wilson ◽  
Aniket Mittal ◽  
Claudia C Dobler ◽  
J Randall Curtis ◽  
Abdul M Majzoub ◽  
...  
Keyword(s):  
Systematic Review ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
High Flow ◽  
Nasal Cannula ◽  
Do Not Resuscitate ◽  
High Flow Nasal Cannula ◽  
Before And After ◽  
Dnr Orders

BACKGROUND AND OBJECTIVES: High-flow nasal cannula (HFNC) oxygen may provide tailored benefits in patients with preset treatment limitations. The objective of this study was to assess the effectiveness of HFNC oxygen in patients with do-not-intubate (DNI) and/or do-not-resuscitate (DNR) orders. METHODS: We conducted a systematic review of interventional and observational studies. A search was performed using MEDLINE, EMBASE, CINAHL, Scopus, and Web of Science, from inception to October 15, 2018. RESULTS: We included six studies evaluating 293 patients. All studies had a high risk of bias. The hospital mortality rates of patients with DNI and/or DNR orders receiving HFNC oxygen were variable and ranged from 40% to 87%. In two before and after studies, the initiation of HFNC oxygen was associated with improved oxygenation and reduced respiratory rates. One comparative study found no difference in dyspnea reduction or morphine doses between patients using HFNC oxygen versus conventional oxygen. No studies evaluated quality of life in survivors or quality of death in nonsurvivors. HFNC was generally well tolerated with few adverse events identified. CONCLUSIONS: While HFNC oxygen remains a viable treatment option for hospitalized patients who have acute respiratory failure and a DNI and/or DNR order, there is a paucity of high-quality, comparative, effectiveness data to guide the usage of HFNC oxygen compared with other treatments, such as noninvasive ventilation, conventional oxygen, and palliative opioids.

scholarly journals High-flow nasal cannula oxygen therapy in acute respiratory failure at Emergency Departments: A systematic review

2020 ◽  
Vol 38 (7) ◽  
pp. 1508-1514
Author(s):  
Nicolas Marjanovic ◽  
Jérémy Guénézan ◽  
Jean-Pierre Frat ◽  
Olivier Mimoz ◽  
Arnaud W. Thille
Keyword(s):  
Systematic Review ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Emergency Departments ◽  
Oxygen Therapy ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula

1093: PALLIATIVE HIGH-FLOW NASAL CANNULA IN ACUTE RESPIRATORY FAILURE: SYSTEMATIC REVIEW AND META-ANALYSIS

2018 ◽  
Vol 46 (1) ◽  
pp. 530-530
Author(s):  
Aniket Mittal ◽  
Abdul Majzoub ◽  
Ognjen Gajic ◽  
Hassan Murad ◽  
Michael Wilson
Keyword(s):  
Systematic Review ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Meta Analysis ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula

High‐flow nasal cannula oxygen therapy for acute respiratory failure in a non‐intensive geriatric setting

2018 ◽  
Vol 18 (12) ◽  
pp. 1652-1653 ◽  
Author(s):  
Filippo Luca Fimognari ◽  
Massimo Rizzo ◽  
Olga Cuccurullo ◽  
Giovanna Cristiano ◽  
Roberto Ricchio ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Oxygen Therapy ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula

scholarly journals The Impact of High-Flow Nasal Cannula on the Outcome of Immunocompromised Patients with Acute Respiratory Failure: A Systematic Review and Meta-Analysis

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 693 ◽  
Author(s):  
Cheng ◽  
Chang ◽  
Wang ◽  
Hsiao ◽  
Lai ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Meta Analysis ◽  
High Flow ◽  
Nasal Cannula ◽  
Immunocompromised Patients ◽  
Intubation Rate ◽  
High Flow Nasal Cannula ◽  
Control Groups ◽  
And Control

Background and objectives: High-flow nasal cannula (HFNC) can be used as a respiratory support strategy for patients with acute respiratory failure (ARF). However, no clear evidence exists to support or oppose HFNC use in immunocompromised patients. Thus, this meta-analysis aims to assess the effects of HFNC, compared to conventional oxygen therapy (COT) and noninvasive ventilation (NIV), on the outcomes in immunocompromised patients with ARF. The Pubmed, Embase and Cochrane databases were searched up to November 2018. Materials and Methods: Only clinical studies comparing the effect of HFNC with COT or NIV for immunocompromised patients with ARF were included. The outcome included the rate of intubation, mortality and length of stay (LOS). Results: A total of eight studies involving 1433 immunocompromised patients with ARF were enrolled. The pooled analysis showed that HFNC was significantly associated with a reduced intubation rate (risk ratio (RR), 0.83; 95% confidence interval (CI), 0.74–0.94, I2 = 0%). Among subgroup analysis, HFNC was associated with a lower intubation rate than COT (RR, 0.86; 95% CI, 0.75–0.95, I2 = 0%) and NIV (RR, 0.59; 95% CI, 0.40–0.86, I2 = 0%), respectively. However, there was no significant difference between HFNC and control groups in terms of 28-day mortality (RR, 0.78; 95% CI, 0.58–1.04, I2 = 48%), and intensive care unit (ICU) mortality (RR, 0.87; 95% CI, 0.73–1.05, I2 = 57%). The ICU and hospital LOS were similar between HFNC and control groups (ICU LOS: mean difference, 0.49 days; 95% CI, −0.25–1.23, I2 = 69%; hospital LOS: mean difference, −0.12 days; 95% CI, −1.86–1.61, I2 = 64%). Conclusions: Use of HFNC may decrease the intubation rate in immunocompromised patients with ARF compared with the control group, including COT and NIV. However, HFNC could not provide additional survival benefit or shorten the LOS. Further large, randomized controlled trials are needed to confirm these findings.

scholarly journals High-flow nasal cannula oxygen therapy to treat patients with hypoxemic acute respiratory failure consequent to SARS-CoV-2 infection

Thorax ◽  
2020 ◽  
Vol 75 (11) ◽  
pp. 998-1000 ◽  
Author(s):  
Andrea Vianello ◽  
Giovanna Arcaro ◽  
Beatrice Molena ◽  
Cristian Turato ◽  
Andi Sukthi ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Hypoxemic Acute Respiratory Failure

This observational study aims to assess the outcome and safety of O2-therapy by high-flow nasal cannula (HFNC) in 28 consecutive patients with severe hypoxemic acute respiratory failure (hARF) consequent to SARS-CoV-2 infection, unresponsive to conventional O2-therapy. Nineteen patients had a positive response. Nine patients required escalation of treatment to non-invasive ventilation (five subsequently intubated). None of the staff had a positive swab testing during the study period and the following 14 days. Severity of hypoxemia and C reactive protein level were correlated with HFNC failure. These data suggest HFNC to be a safe treatment for less severe patients with SARS-CoV-2 hARF and efficacy will need to be assessed as part of a clinical trial.

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