ACP Issues Guideline on High-Flow Nasal Oxygen for Respirato
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For hospitalized patients, high-flow nasal oxygen (HFNO) should be used instead of noninvasive ventilation (NIV) for acute hypoxemic respiratory failure and instead of conventional oxygen therapy (COT) for management of postextubation acute hypoxemic respiratory failure, according to a new clinical guideline issued by the American College of Physicians and published online in the Annals of Internal Medicine.

Researchers conducted a systematic review to examine HFNO versus NIV or COT for acute respiratory failure (ARF) in hospitalized adults. Data were included from 29 randomized controlled trials. The researchers found that HFNO may reduce all-cause mortality, intubation, and hospital-acquired pneumonia and improve patient comfort in initial ARF management compared with NIV, but not in postextubation management. HFNO may reduce reintubation and improve patient comfort compared with COT in postextubation ARF management.

Based on these findings, they suggest use of HFNO instead of NIV for management of acute hypoxemic respiratory failure in hospitalized adults (conditional recommendation; low-certainty evidence). In addition, for hospitalized adults with postextubation acute hypoxemic respiratory failure, HFNO is suggested rather than COT (conditional recommendation; low-certainty evidence).

"More research is needed to identify which patients (for example, high-risk patients) are most likely to benefit from HFNO, particularly by type of acute respiratory failure," researchers write.

Dr. S●●●●p N●●h
Dr. S●●●●p N●●h Internal Medicine
HFNC is a fantasy...pharma driven. It might be less aerosol generating but it' s a huge burden on Oxygen supply.
May 5, 2021Like