![]() High flow nasal cannula (HFNC) blends oxygen and air to deliver a constant FiO2 to a patient. Two high flow devices to consider are those that utilize primarily small-bore cannulas (Vapotherm) and those that utilize large-bore cannulas (Airvo2). With the advancement in technology, new high-flow devices can produce flows similar to that of a ventilator and provide a way to avoid intubation or slow the process of intubation with more patient compliance. These patients were the ideal patients for the use of HFNC. As much as these interventions brought about the necessary changes, there wasn’t always a severe enough need for intubation and not every patient could tolerate BiPAP. Up until then, hypoxic respiratory failure was being treated with a non-rebreather mask, BiPAP, and/or intubation. In the late 1990s, clinicians developed a clinical approach in treating hypoxic respiratory failure with the creation of High Flow Nasal Cannula (HFNC). It is at this point that you (the clinician) can think about implementing HFNC. The patient is hypoxic and is on a non-rebreather mask. Gemelli IRCCS, Rome (Italy), on behalf of the ESICM Review Journal Club.You’re called to the patient’s bedside. Temistocle Taccheri, Fondazione Policlinico A. This article review was prepared and submitted by Drs. According to the ESICM guideline, HFNC is recommended in patients with acute hypoxemic respiratory failure, it is suggested following extubation and post-operative in high-risk patients and it is not recommended in the peri-intubation period. Indications for HFNC oxygen therapy are expanding as evidence on this new technology is growing.
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