Introduction to High-Flow Oxygen Therapy
High-flow oxygen therapy is a modern method of providing oxygen, through nasal cannulas, with a higher volume of heated and humidified air. This special kind of therapy is also known as high-flow nasal cannula (HFNC). It seems to be a promising alternative therapy because it is less complicated and easier. Majorly, this therapy lessens the amount of energy your body expends to breathe. It is the best option for treating patients with acute hypoxia respiratory failure compared to non-invasive ventilation.
HFNC is a non-invasive pulmonary treatment that provides a greater and steady fraction of inspired air (FiO2) at flow rates as much as 60 L/min. It is usually administered via nasal prong (cannula). It’s an acceptable, easy-to-set humidification provider that can be applied perfectly at 37 degrees Celsius.
Duration of High Flow Oxygen Treatment
The duration of high-flow nasal cannula treatment depends on the patient’s condition and can be determined via the medical practitioner’s continuous assessment. A patient’s breathing condition is one of the integral factors that often cause this duration variation. The period of administration may take a short time or a longer one.
Most short-term HFNC therapy commonly occurs in patients who have acute respiratory problems like ARDS, pneumonia, etc. In most cases, this therapy occurs within 30 hours and may be supplied regularly due to the patient’s necessity.
Also, this treatment may be long-term if the respiratory condition is severe. For instance, many COPD or Asthmatic patients tend to use a week or more when having a high flow oxygen therapy. In addition, patient slow RR and oxygenation are some other factors that can cause this delay.
Consideration for Prolonged Use
Sometimes, the use of high-flow oxygen therapy may require the consideration of certain factors. As a healthcare policy maker or provider, some respiratory problems may demand strict decision-making about the duration your patients will use HFNC support. However, to achieve this there are two decision components you need to make. Below are some of this considerable component.
Medical Conditions
- The state of the patient’s breathing system
- Ventilation physiological basis stability.
- Adaptation to gradual FiO2 reduction.
- Status of the problem’s underlying cause.
Patient Selection Criteria
- Tolerance and Compatibility: this is a vital factor to consider. Most patients may find it difficult to use a high-flow cannula due to its interface. However, before you proceed patient consent is needed.
- Some patients may be so selective and worried. You can attend to them with utmost care and carry out the best clinical judgment.
Monitoring and Adjustment
If a patient is placed on high-flow oxygen therapy for a prolonged period, it is advisable to create a routine modification and assessment program. Many times, long-term patients are often assigned specialists who will keep a detailed record of your respiratory progress. One of the quick monitoring services employed for high-flow checks is the breathing vital signs.
Vital Signs Monitoring
Vital signs are some of the medical procedures that help in detecting or monitoring clinical problems. It’s a measure of the body’s functional basis and displays an overview of the human organ. Vital signs comprise various measuring components and respiratory rate is one of them. Respiratory rate measurement is always performed when an individual is at rest. Ideally, the normal rate of healthy adult respiration ranges between 12 to 16 breaths for one minute. Any aberration to this indicates a possible breathing disorder.
Oxygen Saturation Level
The amount of oxygen present in the human body is another factor that can be used to monitor and adjust the rate of oxygen supplied. Normally, the standard percentage of oxygen in the human blood is often 95% or a bit more. Although most people with respiratory disorders like sick apnea can have a SpO2 reading of 90%. These measurements are performed with the help of a small portable device called the pulse oximeter.
Adjustment based on Patient Response
An adjustment can be made to the amount of high-flow oxygen supplied by the HFNC. To know the state of the underlying issue, this adjustment is often performed gradually following the readings obtained from the check. Most of the time, if an HFT patient has a balanced oxygenation level the a gradual reduction of the FiO2. This decreased fraction of inspired oxygen indicates a possibility of a respiratory system.
What Happens After High-Flow Oxygen?
The impact of high-flow oxygen therapy is undiluted and the time frame for this treatment is often determined by the health status of the individual. Sometimes, an indication of improved health is followed by the need for slit reduction changes in the flow of oxygen.
Generally, high-flow treatment increases FiO2, produces positive end-expiratory pressure, cleanses, and decreases dead space. It offers greater comfort compared to cold and dry oxygenation. In addition, it provides a good clearance of fluid due to the presence of humidified air.
As a medical professional, HFNC should be administered to a hypoxic individual who has zero tolerance for noninvasive ventilation. This is because most postoperative non-invasive ventilation or CPAP comes with certain risks, including the need for a controlled environment. Also, the possibility of breathing failure is inevitable due to inadequate patient tolerance to this positive pressure mode of ventilation.
However, if a patient is hyperoxia or insists on using high-flow oxygen therapy a better alternative is the Non-invasive ventilation(NIV). This mode of mechanical ventilation provides a safer and more comfortable process of aiding ventilation compared to the invasive method. NIV makes use of a unique style of ventilation that is flexible, comfortable, and also devoid of airway damage or lung problems.
Non-invasive ventilation uses positive pressure to ventilate the lungs. It comprises various inventions and upcoming developments that make it one of the nondisplaceable ventilation with more positive patient outcomes. Some of the future trends like biocompatibility, portable configurations, enhanced user interface, and a lot more are some of the factors that replicate distinct nature.
References
https://breathe.ersjournals.com/content/16/4/200224
https://pubmed.ncbi.nlm.nih.gov/32147983
https://www.ncbi.nlm.nih.gov/books/NBK553213/#:~:text
https://www.health.state.mn.us/diseases/coronavirus/pulseoximeter.html#:~:text
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764549/#:~:text
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