Contributor: Nick Hatch, MD

Educational Pearls:

• High flow nasal cannula (HFNC) or "heated high flow" can deliver higher oxygen levels than nasal cannula
• It typically is used as an "intermediate" between oxygen via nasal cannula and other non-invasive positive pressure devices, such as BiPAP
• Can modify both the FiO2 and flow rate
• Maximum flow rate is typically 60 liters per minute (compare that to a typical breath that is 30-40 L/min)
• Humidification of HFNC is important due to risk of epistaxis from drying out the nasal mucosa
• Large energy expenditure to humidify airflow by a patient in respiratory distress, so humidified oxygen may help decrease this metabolic demand

References

Nishimura M. High-Flow Nasal Cannula Oxygen Therapy in Adults: Physiological Benefits, Indication, Clinical Benefits, and Adverse Effects. Respir Care. 2016;61(4):529-541. doi:10.4187/respcare.04577

Hacquin A, Perret M, Manckoundia P, et al. High-Flow Nasal Cannula Oxygenation in Older Patients with SARS-CoV-2-Related Acute Respiratory Failure. J Clin Med. 2021;10(16):3515. Published 2021 Aug 10. doi:10.3390/jcm10163515

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

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