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

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 de...

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Bibliographic Details
Published in:Intensive care medicine 2020-12, Vol.46 (12), p.2226-2237
Main 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 E. A.
Format: Article
Language:English
Subjects:
Anesthesiology
Cannulae
Clinical medicine
Clinical practice guidelines
Comparative analysis
Conference Reports and Expert Panel
Critical Care Medicine
Electrical equipment and supplies industry
Emergency Medicine
Evidence-based medicine
Extubation
Intensive
Intensive care
Intubation
Life Sciences
Medical colleges
Medical materials
Medicine
Medicine & Public Health
Oxygen
Pain Medicine
Patients
Pediatrics
Pneumology/Respiratory System
Practice guidelines (Medicine)
Respiratory failure
Surgery
Thoracic surgery
Thorax
Ventilation
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Summary: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.
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-020-06312-y