scholarly journals Awake craniotomy using a high-flow nasal cannula with oxygen reserve index monitoring - A report of two cases -

2021 ◽  
Vol 16 (4) ◽  
pp. 338-343
Author(s):  
Joonhee Gook ◽  
Ji-Hye Kwon ◽  
Keoungah Kim ◽  
Jung Won Choi ◽  
Ik Soo Chung ◽  
...  
Keyword(s):  
High Flow ◽  
Nasal Cannula ◽  
Awake Craniotomy ◽  
Anesthesia Care ◽  
High Flow Nasal Cannula ◽  
Monitored Anesthesia Care ◽  
Cortical Areas ◽  
Fraction Of Inspired Oxygen ◽  
Improve Patient ◽  
Inspired Oxygen

Background: Awake craniotomy is a well-tolerated procedure for the resection of brain tumors residing within or close to the eloquent cortical areas. Monitored anesthesia care (MAC) is a dominant anesthetic approach for awake craniotomy; however, it is associated with inherent challenges such as desaturation and hypercapnia, which may lead to various complications. The prevention of respiratory insufficiency is important for successful awake craniotomy. As measures to avoid respiratory depression, the use of high-flow nasal cannula (HFNC) can improve patient oxygenation and monitor the oxygen reserve index (ORi) to detect hypoxia earlier. Case: We report two cases of awake craniotomy with MAC using HFNC and ORi. We adjusted the fraction of inspired oxygen of the HFNC according to the ORi level. The patient underwent successful awake craniotomy without a desaturation event or additional airway intervention. Conclusions: Combined HFNC and ORi monitoring may provide adequate oxygen reserves in patients undergoing awake craniotomy.

scholarly journals SpO2/FiO2 as a predictor of high flow nasal cannula outcomes in children with acute hypoxemic respiratory failure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ga Eun Kim ◽  
Sun Ha Choi ◽  
Mireu Park ◽  
Jae Hwa Jung ◽  
Myeongjee Lee ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Predictive Factors ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Fraction Of Inspired Oxygen ◽  
Oxygen Ratio ◽  
Inspired Oxygen

AbstractThe high-flow nasal cannula (HFNC) is a useful treatment modality for acute hypoxemic respiratory failure (AHRF) in children. We compared the ability of the oxygen saturation to fraction of inspired oxygen ratio (S/F) and arterial oxygen partial pressure to fraction of inspired oxygen ratio (P/F) to predict HFNC outcomes in children with AHRF. This study included children treated with HFNC due to AHRF from April 2013 to March 2019 at the Severance Children’s Hospital. HFNC failure was defined as the need for mechanical ventilation. Trends of S/F and P/F during HFNC were analyzed. To predict HFNC outcomes, a nomogram was constructed based on predictive factors. A total of 139 patients with arterial blood gas data were included in the S/F and P/F analyses. S/F < 230 at initiation showed high prediction accuracy for HFNC failure (area under the receiver operating characteristic curve: 0.751). Univariate analyses identified S/F < 230 at HFNC initiation and < 200 at 2 h (odds ratio [OR] 12.83, 95% CI 5.06–35.84), and hemato-oncologic disease (OR 3.79, 95% CI 1.12–12.78) as significant predictive factors of HFNC failure. The constructed nomogram had a highly predictive performance, with a concordance index of 0.765 and 0.831 for the exploratory and validation groups, respectively. S/F may be used as a predictor of HFNC outcomes. Our nomogram with S/F for HFNC failure within 2 h may prevent delayed intubation in children with AHRF.

scholarly journals High-flow nasal cannula therapy for adult patients

2016 ◽  
Vol 44 (6) ◽  
pp. 1200-1211 ◽  
Author(s):  
Jian Zhang ◽  
Ling Lin ◽  
Konghan Pan ◽  
Jiancang Zhou ◽  
Xiaoyin Huang
Keyword(s):  
Oxygen Therapy ◽  
Mucociliary Clearance ◽  
High Flow ◽  
Nasal Cannula ◽  
Adult Patients ◽  
Positive Pressure ◽  
High Flow Nasal Cannula ◽  
Fraction Of Inspired Oxygen ◽  
Effective Use ◽  
Inspired Oxygen

High-flow nasal cannula (HFNC) oxygen therapy has several physiological advantages over traditional oxygen therapy devices, including decreased nasopharyngeal resistance, washing out of the nasopharyngeal dead space, generation of positive pressure in the pharynx, increasing alveolar recruitment in the lungs, humidification of the airways, increased fraction of inspired oxygen and improved mucociliary clearance. Recently, the use of HFNC in treating adult critical illness patients has significantly increased, and it is now being used in many patients with a range of different disease conditions. However, there are no established guidelines to direct the safe and effective use of HFNC for these patients. This review article summarizes the available published literature on the positive physiological effects, mechanisms of action, and the clinical applications of HFNC, compared with traditional oxygen therapy devices. The available literature suggests that HFNC oxygen therapy is an effective modality for the early treatment of critically adult patients.

The successful application of high flow nasal cannula for awake craniotomy

2019 ◽  
Vol 55 ◽  
pp. 140-141
Author(s):  
Yi-Chin Lin ◽  
Yin-Tzu Liu ◽  
Zhi-Fu Wu ◽  
Shun-Ming Chan
Keyword(s):  
High Flow ◽  
Nasal Cannula ◽  
Awake Craniotomy ◽  
High Flow Nasal Cannula

scholarly journals High-flow nasal cannula for respiratory failure in adult patients

2021 ◽  
Vol 36 (4) ◽  
pp. 275-285
Author(s):  
SeungYong Park
Keyword(s):  
Respiratory Failure ◽  
Chronic Obstructive Lung Disease ◽  
High Flow ◽  
Nasal Cannula ◽  
Low Flow ◽  
Chronic Obstructive ◽  
High Flow Nasal Cannula ◽  
Hypoxemic Respiratory Failure ◽  
Non Invasive Ventilation ◽  
Fraction Of Inspired Oxygen

The high-flow nasal cannula (HFNC) has been recently used in several clinical settings for oxygenation in adults. In particular, the advantages of HFNC compared with low-flow oxygen systems or non-invasive ventilation include enhanced comfort, increased humidification of secretions to facilitate expectoration, washout of nasopharyngeal dead space to improve the efficiency of ventilation, provision of a small positive end-inspiratory pressure effect, and fixed and rapid delivery of an accurate fraction of inspired oxygen (FiO2) by minimizing the entrainment of room air. HFNC has been successfully used in critically ill patients with several conditions, such as hypoxemic respiratory failure, hypercapneic respiratory failure (exacerbation of chronic obstructive lung disease), post-extubation respiratory failure, pre-intubation oxygenation, and others. However, the indications are not absolute, and much of the proven benefit remains subjective and physiologic. This review discusses the practical application and clinical uses of HFNC in adults, including its unique respiratory physiologic effects, device settings, and clinical indications.

scholarly journals Pulse oximetric saturation to fraction of inspired oxygen (SpO2/FIO2) ratio 24 hours after high-flow nasal cannula (HFNC) initiation is a good predictor of HFNC therapy in patients with acute exacerbation of interstitial lung disease

2020 ◽  
Vol 14 ◽  
pp. 175346662090632
Author(s):  
Takafumi Koyauchi ◽  
Hideki Yasui ◽  
Noriyuki Enomoto ◽  
Hirotsugu Hasegawa ◽  
Hironao Hozumi ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Adverse Events ◽  
Lung Disease ◽  
Acute Exacerbation ◽  
Good Predictor ◽  
High Flow ◽  
High Flow Nasal Cannula ◽  
Respiratory Management ◽  
Fraction Of Inspired Oxygen ◽  
Inspired Oxygen

Background: High-flow nasal cannula (HFNC) oxygen therapy provides effective respiratory management in patients with hypoxemic respiratory failure. However, the efficacy and tolerability of HFNC for patients with acute exacerbation of interstitial lung disease (AE-ILD) have not been established. This study was performed to assess the efficacy and tolerability of HFNC for patients with AE-ILD and identify the early predictors of the outcome of HFNC treatment. Methods: We retrospectively reviewed the records of patients with AE-ILD who underwent HFNC. Overall survival, the success rate of HFNC treatment, adverse events, temporary interruption of treatment, discontinuation of treatment at the patient’s request, and predictors of the outcome of HFNC treatment were evaluated. Results: A total of 66 patients were analyzed. Of these, 26 patients (39.4%) showed improved oxygenation and were successfully withdrawn from HFNC. The 30-day survival rate was 48.5%. No discontinuations at the patient’s request were observed, and no serious adverse events occurred. The pulse oximetric saturation to fraction of inspired oxygen (SpO2/FIO2) ratio 24 h after initiating HFNC showed high prediction accuracy (area under the receiver operating characteristic curve, 0.802) for successful HFNC treatment. In the multivariate logistic regression analysis, an SpO2/FIO2 ratio of at least 170.9 at 24 h after initiation was significantly associated with successful HFNC treatment (odds ratio, 51.3; 95% confidence interval, 6.13–430; p < 0.001). Conclusions: HFNC was well tolerated in patients with AE-ILD, suggesting that HFNC is a reasonable respiratory management for these patients. The SpO2/FIO2 ratio 24 h after initiating HFNC was a good predictor of successful HFNC treatment. The reviews of this paper are available via the supplemental material section.

scholarly journals High-flow nasal cannula improves clinical efficacy of airway management in patients undergoing awake craniotomy

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ping Yi ◽  
Qiong Li ◽  
Zhoujing Yang ◽  
Li Cao ◽  
Xiaobing Hu ◽  
...  
Keyword(s):  
Airway Management ◽  
Clinical Efficacy ◽  
High Flow ◽  
Nasal Cannula ◽  
Awake Craniotomy ◽  
High Flow Nasal Cannula

scholarly journals SPO2/FiO2 as a predictor of high-flow nasal cannula outcomes in children with acute hypoxemic respiratory failure: A retrospective study

2021 ◽  
Author(s):  
Ga Eun Kim ◽  
Sun Ha Choi ◽  
Mi Reu Park ◽  
Jae Hwa Jung ◽  
Myeongjee Lee ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Respiratory Distress ◽  
Odds Ratio ◽  
High Flow ◽  
High Flow Nasal Cannula ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Fraction Of Inspired Oxygen ◽  
Oxygen Ratio ◽  
Inspired Oxygen

Abstract Background: High-flow nasal cannula (HFNC) is a useful treatment modality for respiratory distress in children, as it provides effective oxygenation and reduces the work required for breathing. This study aimed to determine whether the oxygen saturation to fraction of inspired oxygen ratio (S/F) is a better predictor of HFNC outcomes than the arterial oxygen partial pressure to fraction of inspired oxygen ratio (P/F) in children with acute hypoxemic respiratory failure (AHRF).Methods: This study included children treated with HFNC for AHRF between April 2013 and March 2019 at the Severance Children’s Hospital in Korea. HFNC failure was defined as the need for mechanical ventilation due to worsening respiratory distress, whereas HFNC success was defined as the improvement of respiratory distress. We analyzed trends in S/F and P/F during HFNC oxygen therapy. A nomogram was constructed based on predictive factors identified via univariate analysis, and was externally validated using independent data.Results: A total of 139 patients with arterial blood gas data were included in the S/F and P/F analysis. There was a good correlation between S/F and P/F (P<0.001). The S/F at HFNC initiation was <230 and showed a high prediction accuracy for HFNC failure (area under the receiver operating characteristic curve: 0.751). Univariate analyses identified S/F <230 at HFNC initiation, S/F <200 at 2 h (odds ratio, 12.83; 95% confidence interval, 5.06-35.84), and hemato-oncologic disease (odds ratio, 3.79; 95% confidence interval, 1.12-12.78) as significant predictive factors for HFNC failure. These factors were used to construct a nomogram, which was shown to be highly predictive of HFNC outcomes; the concordance index of the exploratory and validation groups were 0.765 and 0.831, respectively.Conclusions: S/F may be used as a predictor of HFNC outcomes. Our nomogram with S/F for HFNC failure within 2 h may be used to prevent delayed intubation in children with AHRF.

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