High Flow Nasal Cannula Liberation: Who, When, and How?

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Tác giả: Matthew G Drake, Howard Freeman, Sarah Tuthill, Kelly C Vranas

Ngôn ngữ: eng

Ký hiệu phân loại: 388.312 Highway services Traffic control

Thông tin xuất bản: United States : Chest , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 30493

High flow nasal cannula (HFNC) is a first-line therapy for patients with acute respiratory failure. Despite increased HFNC utilization over recent years -accelerated in part by the Coronavirus Disease 2019 pandemic - high-quality evidence to guide HFNC discontinuation is lacking. Decisions about when and how quickly to reduce flow rate, fraction of inspired oxygen, or both simultaneously are frequently left to clinicians' discretion without clear guidance on an optimal approach. Failure to de-escalate HFNC support when clinically appropriate has many potential consequences, such as prolongation of ICU/hospital length of stay, increased healthcare costs, and reduced availability of limited hospital resources. With the goal of improving care efficiency and resource utilization among hospitalized patients with acute respiratory failure, we propose a standardized approach for HFNC discontinuation focused on "liberation" (similar to spontaneous breathing trials (SBTs) for patients undergoing mechanical ventilation) using a stepwise approach guided by physiology.
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