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Abstract

Purpose: The aim of this narrative review is to outline the mechanism of action of HFNC therapy, the clinical benefits of its use, cautions of its clinical application and limitations of previous research. Methods: A literature review was conducted using the following databases as sources: Medline, PubMed, and Google Scholar. Only publications written in English were used in this clinical review. Keywords used in the search included the following: high-flow nasal cannula, heated humidified oxygen, oxygen therapy, non-invasive ventilation, and respiratory failure. Results: The literature reveals HFNC therapy significantly decreased the use of mechanical ventilation (invasive or non-invasive) in patients experiencing respiratory failure. HFNC therapy was better tolerated by patients and decreased the patient’s work of breathing when compared to a conventional oxygen therapy (i.e., non-rebreather oxygen mask). Other clinical benefits of using HFNC when changing a patient from conventional facemask oxygen therapy to a HFNC device are significant improvements in PaO2, respiratory rate and overall comfort. Conclusions: High flow nasal cannula (HFNC) therapy serves as an alternative to conventional oxygen therapy to deliver elevated concentrations of oxygen to patients experiencing acute respiratory failure. Information detailed in this article suggests HFNC therapy is an effective therapy for improving a patient’s oxygenation status when experiencing acute respiratory failure in adults. The literature reveals, it is reasonable to initiate HFNC in adults with acute hypoxemic respiratory failure without hypercapnia, as an alternative to standard oxygen therapy or noninvasive positive pressure ventilation.

Author Bio(s)

Joshua F. Gonzales, MHA, RRT-NPS, RRT-SDS, is an Associate Professor of Respiratory Care in the College of Health Professions at Texas State University in San Marcos, TX. He is a licensed respiratory care practitioner in the state of Texas.

Kevin P. Collins, MSc, RRT-RPFT, AE-C, is an Associate Professor of Respiratory Care in the College of Health Professions at Texas State University in San Marcos, TX. He is a licensed respiratory care practitioner in the state of Texas.

Christopher J. Russian, Ph.D., RRT-NPS, RPSGT, RST, is a Professor of Respiratory Care in the College of Health Professions at Texas State University in San Marcos, TX. He is a licensed respiratory care practitioner in the state of Texas.

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