The role for high flow nasal cannula as a respiratory support strategy in adults: a clinical practice guideline Academic Article uri icon

  •  
  • Overview
  •  
  • Research
  •  
  • Identity
  •  
  • Additional Document Info
  •  
  • View All
  •  

abstract

  • PURPOSE: High flow nasal cannula (HFNC) is a relatively recent respiratory support technique which delivers high flow, heated and humidified controlled concentration of oxygen via the nasal route. Recently, its use has increased for a variety of clinical indications. To guide clinical practice, we developed evidence-based recommendations regarding use of HFNC in various clinical settings. METHODS: We formed a guideline panel composed of clinicians, methodologists and experts in respiratory medicine. Using GRADE, the panel developed recommendations for four actionable questions. RESULTS: The guideline panel made a strong recommendation for HFNC in hypoxemic respiratory failure compared to conventional oxygen therapy (COT) (moderate certainty), a conditional recommendation for HFNC following extubation (moderate certainty), no recommendation regarding HFNC in the peri-intubation period (moderate certainty), and a conditional recommendation for postoperative HFNC in high risk and/or obese patients following cardiac or thoracic surgery (moderate certainty). CONCLUSIONS: This clinical practice guideline synthesizes current best-evidence into four recommendations for HFNC use in patients with hypoxemic respiratory failure, following extubation, in the peri-intubation period, and postoperatively for bedside clinicians.

authors

  • Rochwerg, Bram
  • Einav, Sharon
  • Chaudhuri, Dipayan
  • Mancebo, Jordi
  • Mauri, Tommaso
  • Helviz, Yigal
  • Goligher, Ewan C
  • Jaber, Samir
  • Ricard, Jean-Damien
  • Rittayamai, Nuttapol
  • Roca, Oriol
  • Antonelli, Massimo
  • Maggiore, Salvatore Maurizio
  • Demoule, Alexandre
  • Hodgson, Carol L
  • Mercat, Alain
  • Wilcox, M Elizabeth
  • Granton, David
  • Wang, Dominic
  • Azoulay, Elie
  • Ouanes-Besbes, Lamia
  • Cinnella, Gilda
  • Rauseo, Michela
  • Carvalho, Carlos
  • Dessap-Mekontso, Armand
  • Fraser, John
  • Frat, Jean-Pierre
  • Gomersall, Charles
  • Grasselli, Giacomo
  • Hernandez, Gonzalo
  • Jog, Sameer
  • Pesenti, Antonio
  • Riviello, Elisabeth D
  • Slutsky, Arthur S
  • Stapleton, Renee D
  • Talmor, Daniel
  • Thille, Arnaud W
  • Brochard, Laurent
  • Burns, Karen EA

publication date

  • December 2020