High-Flow-Sauerstofftherapie – Schritt für Schritt

2020 ◽  
Vol 145 (10) ◽  
pp. 693-697 ◽  
Author(s):  
Christian Wachs ◽  
Jörn Grensemann ◽  
Stefan Kluge
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Gas Flow ◽  
Oxygen Therapy ◽  
Flow Regulation ◽  
High Flow ◽  
High Flow Oxygen

AbstractIn recent years, high-flow oxygen therapy (HFNC) has become established and proven as an oxygenation method for patients with severe respiratory restrictions in most intensive care units. Advantages of this method, which is used especially for patients with hypoxaemia, are the easy application and the compliance by the patient. Devices are used which enable individual oxygen therapy by means of humidification, warming up and gas flow regulation options.

High-flow oxygen therapy and other inhaled therapies in intensive care units

The Lancet ◽  
2016 ◽  
Vol 387 (10030) ◽  
pp. 1867-1878 ◽  
Author(s):  
Sean D Levy ◽  
Jehan W Alladina ◽  
Kathryn A Hibbert ◽  
R Scott Harris ◽  
Ednan K Bajwa ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Oxygen Therapy ◽  
High Flow ◽  
High Flow Oxygen

High Flow Nasal Oxygen Therapy Usage in the Adult Intensive Care Units in Turkey: Multi-center, Prospective Study

2019 ◽  
Author(s):  
Fatma Bodur Yildirim ◽  
Serpil Öcal ◽  
Ebru Ersoy Ortac ◽  
Ömer Zühtü Yöndem ◽  
Barıs Ecevit Yüksel ◽  
...  
Keyword(s):  
Intensive Care ◽  
Prospective Study ◽  
Intensive Care Units ◽  
Oxygen Therapy ◽  
High Flow

scholarly journals Physiological effects of high-flow oxygen in tracheostomized patients

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Daniele Natalini ◽  
Domenico L. Grieco ◽  
Maria Teresa Santantonio ◽  
Lucrezia Mincione ◽  
Flavia Toni ◽  
...  
Keyword(s):  
Respiratory Rate ◽  
Airway Pressure ◽  
Gas Flow ◽  
Oxygen Therapy ◽  
High Flow ◽  
Mean Difference ◽  
Physiological Effects ◽  
Arterial Blood ◽  
High Flow Oxygen ◽  
Tracheal Pressure

Abstract Background High-flow oxygen therapy via nasal cannula (HFOTNASAL) increases airway pressure, ameliorates oxygenation and reduces work of breathing. High-flow oxygen can be delivered through tracheostomy (HFOTTRACHEAL), but its physiological effects have not been systematically described. We conducted a cross-over study to elucidate the effects of increasing flow rates of HFOTTRACHEAL on gas exchange, respiratory rate and endotracheal pressure and to compare lower airway pressure produced by HFOTNASAL and HFOTTRACHEAL. Methods Twenty-six tracheostomized patients underwent standard oxygen therapy through a conventional heat and moisture exchanger, and then HFOTTRACHEAL through a heated humidifier, with gas flow set at 10, 30 and 50 L/min. Each step lasted 30 min; gas flow sequence during HFOTTRACHEAL was randomized. In five patients, measurements were repeated during HFOTTRACHEAL before tracheostomy decannulation and immediately after during HFOTNASAL. In each step, arterial blood gases, respiratory rate, and tracheal pressure were measured. Results During HFOTTRACHEAL, PaO2/FiO2 ratio and tracheal expiratory pressure slightly increased proportionally to gas flow. The mean [95% confidence interval] expiratory pressure raise induced by 10-L/min increase in flow was 0.2 [0.1–0.2] cmH2O (ρ = 0.77, p < 0.001). Compared to standard oxygen, HFOTTRACHEAL limited the negative inspiratory swing in tracheal pressure; at 50 L/min, but not with other settings, HFOTTRACHEAL increased mean tracheal expiratory pressure by (mean difference [95% CI]) 0.4 [0.3–0.6] cmH2O, peak tracheal expiratory pressure by 0.4 [0.2–0.6] cmH2O, improved PaO2/FiO2 ratio by 40 [8–71] mmHg, and reduced respiratory rate by 1.9 [0.3–3.6] breaths/min without PaCO2 changes. As compared to HFOTTRACHEAL, HFOTNASAL produced higher tracheal mean and peak expiratory pressure (at 50 L/min, mean difference [95% CI]: 3 [1–5] cmH2O and 4 [1–7] cmH2O, respectively). Conclusions As compared to standard oxygen, 50 L/min of HFOTTRACHEAL are needed to improve oxygenation, reduce respiratory rate and provide small degree of positive airway expiratory pressure, which, however, is significantly lower than the one produced by HFOTNASAL.

scholarly journals How to beat COVID-19: Know your enemy well

2020 ◽  
Vol 4 (1-3) ◽  
pp. 5
Author(s):  
Santiago Herrero
Keyword(s):  
Cardiovascular Disease ◽  
Cystic Fibrosis ◽  
Intensive Care ◽  
Oxygen Therapy ◽  
High Flow ◽  
Severe Respiratory Failure ◽  
High Flow Oxygen ◽  
Infection And Inflammation ◽  
Seriously Ill

Anyone is at risk of contracting COVID-19 if exposed to the virus. Some people are more likely to become seriously ill than others, which means they may need hospitalization, intensive care, or respiratory support (respirator mask, high flow oxygen therapy, ventilators, etc.), and some may even die, mainly by severe respiratory failure. Those patients with asthma (moderate to severe), cardiovascular disease, cystic fibrosis, hypertension, immunosuppression, liver disease, pregnancy, smoker, thalassemia and diabetes (especially type 1) have a higher risk of getting sick and suffering the disease with more virulence and potential mortality. The older people are in risk because the chronical diseases and comorbidities are associate with the aging.This presentation aims to explain the mechanisms of infection and inflammation by the coronavirus in order to act primarily on them. If you know your enemy well, you can treat it from an etiopathogenic perspective.

High Flow Oxygen Therapy and the Pressure to Feed Infants With Acute Respiratory Illness

2020 ◽  
Vol 5 (4) ◽  
pp. 1006-1010
Author(s):  
Jennifer Raminick ◽  
Hema Desai
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Oxygen Therapy ◽  
Respiratory Illness ◽  
High Flow ◽  
Oral Feeding ◽  
Respiratory Support ◽  
Acute Respiratory Illness ◽  
High Flow Oxygen

Purpose Infants hospitalized for an acute respiratory illness often require the use of noninvasive respiratory support during the initial stage to improve their breathing. High flow oxygen therapy (HFOT) is becoming a more popular means of noninvasive respiratory support, often used to treat respiratory syncytial virus/bronchiolitis. These infants present with tachypnea and coughing, resulting in difficulties in coordinating sucking and swallowing. However, they are often allowed to feed orally despite having high respiratory rate, increased work of breathing and on HFOT, placing them at risk for aspiration. Feeding therapists who work with these infants have raised concerns that HFOT creates an additional risk factor for swallowing dysfunction, especially with infants who have compromised airways or other comorbidities. There is emerging literature concluding changes in pharyngeal pressures with HFOT, as well as aspiration in preterm neonates who are on nasal continuous positive airway pressure. However, there is no existing research exploring the effect of HFOT on swallowing in infants with acute respiratory illness. This discussion will present findings from literature on HFOT, oral feeding in the acutely ill infant population, and present clinical practice guidelines for safe feeding during critical care admission for acute respiratory illness. Conclusion Guidelines for safety of oral feeds for infants with acute respiratory illness on HFOT do not exist. However, providers and parents continue to want to provide oral feeds despite clinical signs of respiratory distress and coughing. To address this challenge, we initiated a process change to use clinical bedside evaluation and a “cross-systems approach” to provide recommendations for safer oral feeds while on HFOT as the infant is recovering from illness. Use of standardized feeding evaluation and protocol have improved consistency of practice within our department. However, further research is still necessary to develop clinical practice guidelines for safe oral feeding for infants on HFOT.

Sign in / Sign up

Export Citation Format

Share Document