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- Title
The role for high flow nasal cannula as a respiratory support strategy in adults: a clinical practice guideline.
- 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
- Abstract
<bold>Purpose: </bold>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.<bold>Methods: </bold>We formed a guideline panel composed of clinicians, methodologists and experts in respiratory medicine. Using GRADE, the panel developed recommendations for four actionable questions.<bold>Results: </bold>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).<bold>Conclusions: </bold>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.
- Subjects
NASAL cannula; RESPIRATORY insufficiency; OXYGEN therapy; CLINICAL indications; THORACIC surgery; CARDIAC surgery
- Publication
Intensive Care Medicine, 2020, Vol 46, Issue 12, p2226
- ISSN
0342-4642
- Publication type
journal article
- DOI
10.1007/s00134-020-06312-y