UNDERSTANDING HIGH FLOW NASAL CANNULA | HFNC |

In the ever-evolving landscape of patient care, innovations such as High-Flow Nasal Cannula (HFNC) have emerged as a game-changer, particularly in intensive care units (ICUs) and emergency departments (EDs). This noninvasive ventilation method has shown its potential to significantly impact patient outcomes compared to conventional oxygen therapy. In this article, we delve into the mechanisms of action, clinical studies, and physiological effects of HFNC, highlighting its relevance in treating critically ill patients, including those with acute hypoxemic respiratory failure and acute respiratory distress syndrome.
The Basics of High-Flow Nasal Cannula
HFNC is an innovative respiratory support system that delivers high-flow oxygen through nasal prongs to adult patients. Unlike traditional oxygen delivery methods such as standard nasal cannulas or face masks, HFNC provides high-flow oxygen blended with room air using an oxygen blender.
Key Components:
Oxygen Blender: The oxygen blender allows precise control over the fraction of inspired oxygen (FiO2), enabling tailored therapy for patients. It is a critical component of HFNC’s efficacy.
Heated Humidifier: HFNC incorporates a heated humidifier to provide warm and humidified gas to patients. This maintains airway humidity, ensuring patient comfort and reducing the risk of drying and irritation.
High Flow Rates: HFNC delivers high flow rates, typically ranging from 20 to 60 liters per minute (L/min). These high flow rates help wash out the anatomical dead space and reduce the work of breathing.
High Flow Nasal Cannula Mechanisms of Action
Optimal Oxygenation: HFNC ensures patients receive an optimal oxygen level, improving oxygenation. This is crucial in managing critically ill patients.
Positive End-Expiratory Pressure (PEEP): HFNC can create slight positive pressure in the oropharynx
Reduction in Work of Breathing: HFNC offers continuous positive airway pressure (CPAP), which reduces the work of breathing. This is particularly beneficial for patients in respiratory distress.
Washout of Dead Space: The high flow rates effectively wash out the anatomical dead space, minimizing the rebreathing of exhaled carbon dioxide (CO2) and enhancing ventilation.
Enhanced Oxygenation: High Flow Nasal Cannula (HFNC) offers a unique advantage by delivering high and consistent fractions of inspired oxygen (FiO2). This improved oxygenation is due to the capability of HFNC to provide a flow rate that meets or exceeds the patient’s peak inspiratory flow rate, leading to:
Consistent FiO2: Reduced entrainment of room air, resulting in a stable and predictable FiO2.
High Flow Rates: Allows delivery of flow rates up to 60 L/min, ensuring the set FiO2 is maintained.
Positive End-Expiratory Pressure (PEEP):While not a replacement for the PEEP delivered by mechanical ventilators, the HFNC does create a slight positive pressure in the oropharynx:
Alveolar Recruitment: Helps in keeping alveoli open, potentially improving oxygenation.
Counterbalance Intrinsic PEEP: Can counteract auto-PEEP in chronic obstructive pulmonary disease (COPD) patients.
Decreased Work of Breathing : HFNC has shown to assist in decreasing the work of breathing in some patients:
Meeting Inspiratory Demand: By matching or exceeding the patient’s peak inspiratory flow rate.
Enhanced Carbon Dioxide (CO2) Washout: Efficient removal of CO2 from the anatomical dead space.
Optimal Humidification and Warming : HFNC systems typically include an active humidifier which provides several physiological advantages:
Maintains Mucociliary Function: Optimal humidification ensures the integrity of the mucociliary system.
Prevents Mucosal Drying: Reduces the discomfort often seen with traditional oxygen therapies.
Warming: Warm gases mimic physiological conditions, improving comfort and aiding in mucosal function.
Reduced Anatomical Dead Space :The high flow rates provided by HFNC help in:Dilution of Fresh Gas: With the existing alveolar gas, improving the efficiency of gas exchange.
You can purchase of even rent High Flow Oxygen Cannula from Bajaj Technovision.
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#High-Flow Nasal Cannula (HFNC)
#Oxygen Therapy
#Respiratory Support
#Humidified Oxygen
#Non-Invasive Ventilation (NIV)