High Flow Oxygen Therapy
nice Neotech’s High Flow Oxygen Therapy is a combination of Servo controlled Heated (Respiratory) Humidifier – nice 8050 and an Air Oxygen Blender – nice 5005/nice 5010 with cascaded blenders of up to 15 LPM or 30 LPM or 60 LPM output flow.
This article helps to understand the concept, its benefits, side effects, usage, and application of High Flow Oxygen Therapy (HFOT) in respiratory care.
Respiratory Care (NICU)
High-flow therapy has shown to be useful in both Adult and Infant/Pediatric Intensive Care settings.
High flow Oxygen Therapy is a type of non-invasive spontaneous breathing support that delivers a high flow of medical gas to a patient through an interface that is used in the hospital where oxygen often in conjunction with compressed air and humidification is delivered to a patient at rates of flow higher than that delivered traditionally in oxygen therapy. Servo controlled Humidifier with flow detection sensor provides humidity to the delivered gas of the patient. HFOT is helping to reduce breathing issues which are only offered if traditional oxygen therapy is not helping the patients. By decreasing the effort of breathing and creating a small amount of positive pressure in the upper airways, this therapy helps improve oxygen delivery.
Benefits:
High-flow nasal cannula oxygen therapy (HFNC) can provide innovative respiratory support for critically ill patients with acute hypoxemic respiratory failure. Lengths of stay either in the hospital or in the intensive care unit and can also prevent subsequent intubation. It does however reduce the need for tracheal intubation (by 15%) and escalation of oxygenation and respiratory support.
Moreover, recent studies suggested that HFNC is effective in Conditions such as general respiratory failure, asthma exacerbation, hypercapnic patients COPD exacerbation with a stable status, bronchiolitis, sleep apnoea, pneumonia, and congestive heart failure are all possible situations where high-flow therapy may be indicated. HHHF has been used in spontaneously breathing patients during general anesthesia to facilitate surgery for airway obstruction.
During the use of HFOT the patient can speak. As this is a non-invasive therapy, it avoids the risk of ventilator-associated pneumonia in situations where it can supplant the use of a ventilator.
Mechanism:
High-flow nasal cannula (HFNC) therapy is an oxygen supply system capable of delivering up to 100% humidified and heated oxygen with a controlled fraction of inspired oxygen (FiO2) could be varied from 21% to 100%, Cascaded flow meters at a flow rate of up to 60 liters per minute via a nasal cannula whereas Traditional oxygen therapy is up to 15 Litres Per Minute. High flow oxygen therapy is usually delivered using a blender connected to a wall outlet, a heated humidifier, heated tubing, and a nasal cannula. A highly calibrated blender ensures an accurate % of oxygen delivered. Preset pressure manifold that releases the additional pressure ensures accurate delivery of the set pressure and safety to the patient. Optimal humidity of greater than 33 mg/l promotes mucociliary clearance and decreases the patient’s work of breathing, and serves as an alternative to more invasive forms of treatment, such as mechanical ventilation. This flow, being delivered through a small diameter delivery system and small-bore nasal cannula allows the flow that would traditionally move slowly through the upper airway to move quickly and maintain a constant stream of fresh gas which effectively washes out upper airway dead space.
Difference between Bubble CPAP & HFOT:
Results showed that HFNC was not inferior to CPAP in reintubation rates. Oxygenation was shown to improve more with CPAP than HFNC but arterial carbon dioxide (PaCO2) was shown to decrease faster with HFNC. HFNC is suggested to reduce the upper airway dead space and resistance. CPAP did have a higher rate of discontinuation of use and of skin breakdown. Adult patients show less skin damage with HFNC than CPAP treatment. CPAP is a high flow system and is able to generate a positive end-expiratory pressure. However, the certainty that this result is reliable is low, as different studies were less precise than they could have been. People on nasal high flow feel more comfortable, less breathless, increase in End-Expiratory Lung volumes and there was little evidence of harm.
Side Effects:
Unwarmed and dry gas may have adverse effects on patients with respiratory failure. Conventional oxygen devices are associated with mask discomfort, nasal dryness, oral dryness, eye irritation, nasal and eye trauma, and gastric distention.
Usage in Neonatal Intensive Care Unit
High-flow therapy has shown to be useful in neonatal intensive care (NICU) settings for premature infants with Infant respiratory distress syndrome, as it prevents many infants from needing artificial ventilation via intubation, and allows safe respiratory management at lower FiO2 levels, and thus reduces the risk of retinopathy of prematurity and Oxygen toxicity. Due to the decreased stress of effort needed to breathe, the neonatal body is able to spend more time utilizing metabolic efforts elsewhere, which causes decreased days on a mechanical ventilator, faster weight gain, and overall decreased hospital stay entirely.
High flow therapy has been successfully implemented in infants and older children. The cannula improves respiratory distress, oxygen saturation, and the patient’s comfort. Its mechanism of action is the application of mild positive airway pressure and lung volume recruitment.
Application:
Level II NICU Level III NICU Infant Pediatric & Adult Respiratory Care
Corporate Office
nice Neötech Medical Systems Pvt. Ltd.,85 and 86, Krishna Industrial Estate,Vanagaram, Mettukuppam,Chennai – 600095, Tamil Nadu, INDIA.
Phone: +91-44-24764608 | 24762594 | 98408 73602
Fax: +91-44-24766920
Email: info@niceneotech.com | marketing@niceneotech.com
