We used a high-flow nasal cannula with a patient who required a high fraction of inspired oxygen but could not tolerate a nasal or facial mask. We saw a 92-year-old woman with delirium and dementia in the intensive care unit for multi-lobar pneumonia with severe hypoxemia. Attempts to oxygenate the patient failed because she was unable to tolerate various facial and nasal masks. We then tried a...

High flow nasal cannula (HFNC) supportive therapy has emerged as a safe, useful therapy in patients with respiratory failure, improving oxygenation and comfort. Recently several clinical trials have analyzed the effectiveness of HFNC therapy in different clinical situations and have reported promising results. Here we review the current knowledge about HFNC therapy, from its mechanisms of actio...

OBJECTIVE To determine whether lung volume changes and breathing pattern parameters differ among 3 devices for delivery of nasal continuous positive airway pressure (CPAP) in premature infants. METHODS Thirty-two premature infants receiving nasal CPAP for apnea or mild respiratory distress were enrolled. Birth weight was (mean +/- standard deviation) 1081 +/- 316 g, gestational age 29 +/- 2 w...

BACKGROUND The position of the jet or ultrasonic nebulizer in the ventilator circuit impacts drug delivery during mechanical ventilation, but has not been extensively explored, and no study has examined all of the commonly used nebulizers. METHODS Drug delivery from jet, vibrating-mesh, and ultrasonic nebulizers and pressurized metered-dose inhaler (pMDI) with spacer was compared in a model o...

STUDY OBJECTIVES The published AASM guidelines approve use of a nasal cannula/pressure transducer to detect apneas/hypopneas, but require esophageal manometry for Respiratory Effort-Related Arousals (RERAs). However, esophageal manometry may be poorly tolerated by many subjects. We have shown that the shape of the inspiratory flow signal from a nasal cannula identifies flow limitation and eleva...

BACKGROUND Patients with do-not-intubate (DNI) status and respiratory failure are commonly treated with noninvasive ventilation (NIV). High-flow nasal cannula (HFNC) therapy supplies a high flow of heated and humidified oxygen that may provide an effective alternative to NIV. We assessed the efficacy of HFNC in DNI patients with hypoxemic respiratory distress. METHODS We identified 50 DNI pat...

Background: Neonatal acute respiratory distress is a common cause for mortality and morbidity in preterm neonates. Non-invasive ventilation crucial neonates, nasal intermittent positive pressure continuous airway pressure. Recently, heated humidified high-flow cannula modes have been revealed as more efficient non-invasive mode improving functional residual capacity however, other studies quest...