Physiologic Effects of High-Flow Nasal Cannula in Acute Hypoxemic Respiratory Failure.
Tommaso Mauri,Cecilia Turrini,Nilde Eronia,Giacomo Grasselli,Carlo Alberto Volta,Giacomo Bellani,Antonio Pesenti +6 more
TL;DR: In patients with AHRF, HFNC exerts multiple physiologic effects including less inspiratory effort and improved lung volume and compliance, which might underlie the clinical efficacy of HFNC.
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Abstract: Rationale: High-flow nasal cannula (HFNC) improves the clinical outcomes of nonintubated patients with acute hypoxemic respiratory failure (AHRF).Objectives: To assess the effects of HFNC on gas exchange, inspiratory effort, minute ventilation, end-expiratory lung volume, dynamic compliance, and ventilation homogeneity in patients with AHRF.Methods: This was a prospective randomized crossover study in nonintubated patients with AHRF with PaO2/setFiO2 less than or equal to 300 mm Hg admitted to the intensive care unit. We randomly applied HFNC set at 40 L/min compared with a standard nonocclusive facial mask at the same clinically set FiO2 (20 min/step).Measurements and Main Results: Toward the end of each phase, we measured arterial blood gases, inspiratory effort, and work of breathing by esophageal pressure swings (ΔPes) and pressure time product, and we estimated changes in lung volumes and ventilation homogeneity by electrical impedance tomography. We enrolled 15 patients aged 60 ± 14 years old with P...
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High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure.
Jean-Pierre Frat,Arnaud W. Thille,Alain Mercat,Christophe Girault,Stéphanie Ragot,Sébastien Perbet,Gwenaël Prat,Thierry Boulain,Elise Morawiec,Alice Cottereau,Jérôme Devaquet,Saad Nseir,Keyvan Razazi,Jean-Paul Mira,Laurent Argaud,Jean-Charles Chakarian,Jean-Damien Ricard,Xavier Wittebole,Stéphanie Chevalier,Alexandre Herbland,Muriel Fartoukh,Jean-Michel Constantin,Jean-Marie Tonnelier,Marc Pierrot,Armelle Mathonnet,Gaetan Beduneau,Celine Deletage-Metreau,Jean-Christophe M. Richard,Laurent Brochard,René Robert +29 more
TL;DR: In patients with nonhypercapnic acute hypoxemic respiratory failure, treatment with high-flow oxygen, standard oxygen, or noninvasive ventilation did not result in significantly different intubation rates, and there was a significant difference in favor of high- flow oxygen in 90-day mortality.
Mechanical Ventilation to Minimize Progression of Lung Injury in Acute Respiratory Failure
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Pulmonary dead-space fraction as a risk factor for death in the acute respiratory distress syndrome.
Thomas J. Nuckton,James A Alonso,Richard H Kallet,Brian M. Daniel,Jean-Francois Pittet,Mark D. Eisner,Michael A. Matthay +6 more
TL;DR: Increased dead-space fraction is a feature of the early phase of the acute respiratory distress syndrome and Elevated values are associated with an increased risk of death.
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Nasal high-flow versus Venturi mask oxygen therapy after extubation. Effects on oxygenation, comfort, and clinical outcome
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TL;DR: Compared with the Venturi mask, NHF results in better oxygenation for the same set FiO2 after extubation, and use of NHF is associated with better comfort, fewer desaturations and interface displacements, and a lower reintubation rate.
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