en
Scientific article
Review
Open access
English

High-flow nasal oxygen in acute hypoxemic respiratory failure: A narrative review of the evidence before and after the COVID-19 pandemic

Published inFrontiers in medicine, vol. 9, 1068327
Publication date2022-11-25
First online date2022-11-25
Abstract

High-flow nasal oxygen (HFNO) is a type of non-invasive advanced respiratory support that allows the delivery of high-flow and humidified air through a nasal cannula. It can deliver a higher inspired oxygen fraction than conventional oxygen therapy (COT), improves secretion clearance, has a small positive end-expiratory pressure, and exhibits a washout effect on the upper air space that diminishes dead space ventilation. HFNO has been shown to reduce the work of breathing in acute hypoxemic respiratory failure (AHRF) and has become an interesting option for non-invasive respiratory support. Evidence published before the COVID-19 pandemic suggested a possible reduction of the need for invasive mechanical ventilation compared to COT. The COVID-19 pandemic has resulted in a substantial increase in AHRF worldwide, overwhelming both acute and intensive care unit capacity in most countries. This triggered new trials, adding to the body of evidence on HFNO in AHRF and its possible benefits compared to COT or non-invasive ventilation. We have summarized and discussed this recent evidence to inform the best supportive strategy in AHRF both related and unrelated to COVID-19.

eng
Keywords
  • COVID-19
  • Acute hypoxemic respiratory failure
  • Bi-level airway pressure
  • Continuous positive air pressure
  • High flow nasal oxygen
  • Non-invasive ventilation
Citation (ISO format)
GENECAND, Léon et al. High-flow nasal oxygen in acute hypoxemic respiratory failure: A narrative review of the evidence before and after the COVID-19 pandemic. In: Frontiers in medicine, 2022, vol. 9, p. 1068327. doi: 10.3389/fmed.2022.1068327
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Identifiers
ISSN of the journal2296-858X
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Technical informations

Creation03/10/2023 9:40:50 AM
First validation09/19/2023 9:55:50 AM
Update time09/19/2023 9:55:50 AM
Status update09/19/2023 9:55:50 AM
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