Hypoxemia
Conditions
Keywords
High flow nasal cannula, Hypoxemia, Flow setting
Brief summary
High flow nasal cannula (HFNC) delivers oxygen at a flow which exceeds the patient's inspiratory flow demand in order to improve oxygenation. Numerous randomized control trials and meta-analyses have shown that HFNC improves oxygenation and helps avoid intubation in hypoxemic patients, as well as reduce work of breathing, improve ventilation, and decrease hypercapnia in COPD patients. Flow settings play a critical role when using HFNC, as increased flow can reduce inspiratory effort, improve ventilation, and dynamic lung compliance. However, flow rates used in many studies vary widely. The clinical effects of different HFNC flow setting, specifically to match or over than a patients' own inspiratory flow, is still unknown.
Detailed description
High flow nasal cannula (HFNC) delivers oxygen at a flow which exceeds the patient's inspiratory flow demand in order to improve oxygenation. Numerous randomized control trials and meta-analyses have shown that HFNC improves oxygenation and helps avoid intubation in hypoxemic patients, as well as reduce work of breathing, improve ventilation, and decrease hypercapnia in COPD patients. Flow settings play a critical role when using HFNC, as increased flow can reduce inspiratory effort, improve ventilation, and dynamic lung compliance. However, flow rates used in many studies vary widely, from 20-40 LPM in COPD patients and 30-60 LPM in hypoxemic patients. The clinical effects of different HFNC flow setting, specifically to match or over than a patients' own inspiratory flow, is still unknown.
Interventions
OTHERHFNC flow
HFNC flow will be titrated based on the hospital's policy or protocol for hypoxemic patients and research protocol for healthy volunteers
Sponsors
Rush University Medical Center
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Masking description
The participant will be masked by the flow setting
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
Yes
Inclusion criteria
Adult patients (Age \> 18yrs and \< 90yrs) who need nasal cannula oxygen flow ≥ 5 L/min to maintain SpO2 at 90-97%.
Exclusion criteria
(Common): - Unable to use resuscitation mask, such as facial trauma, claustrophobia * Inability to verbally communicate; * Pregnant * Inability to breathe via nose, such as nasosinusitis, stuffy nose or nasal obstruction, etc. * Ordered SpO2 goal is above 97% * FIO2 needs ≤ 0.4 * Using inhaled pulmonary vasodilator via HFNC
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| SpO2/FIO2 increment for hypoxemic patients | 30 minutes | SpO2/FIO2 at the optimal/maximum /tolerable/ HFNC flow setting compared to the SpO2/FIO2 at HFNC flow matching patient's inspiratory flow or 30 L/min for hypoxemic patients |
| RR change for hypoxemic patients | 30 minutes | Respiratory rates at the optimal/maximum /tolerable/ HFNC flow setting compared to the SpO2/FIO2 at HFNC flow matching patient's inspiratory flow or 30 L/min for hypoxemic patients |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| comfort scores | 30 minutes | comfort will be self-evaluation using a visual analog scale with measured score of 0 is the worst and 10 is the best |
Countries
United States
Outcome results
None listed