Abstract
Rationale: Administration of oxygen via mask or low flow nasal cannula is standard during breaks off NIV. HFNC is an oxygen delivery system capable of generating flows up to 60 l/min and FIO2 up to 100%.
Aim: To assess whether HFNC allows for longer NIV breaks and is more beneficial than SO when off NIV.
Methods: Patients on NIV due to acute respiratory failure (ARF) were randomized to SO (n=19) or HFNC (n=21) during breaks off NIV. Data were collected at the end of each NIV session and break, for up to 6 breaks.
Results: Baseline demographics and comorbidities were similar, except for BMI (34.8±10.1 vs 27.7±8.8,p=0.02), heart rate (HR) (88±18 vs 103±22,p=0.03), and pneumonia as cause of ARF (3 vs 10,p=0.04), all SO vs HFNC, respectively. Cumulative (1201±645 vs 1409±640 min) and proportionate (.48±.23 vs .53±.23) time on breaks were similar, as were vital signs except HR, which was persistently higher in the HFNC arm. Comfort level on HFNC was significantly higher compared to SO and to NIV in subjects in the HFNC arm. Dyspnea score was significantly lower on HFNC than SO, and it was similar to that on NIV in subjects in the HFNC arm (Fig 1).
Conclusion: Although HFNC did not significantly lengthen the duration of breaks off NIV, it is more comfortable than SO and NIV and reduces dyspnea more than SO. Thus, HFNC is a desirable alternative to SO as a rest therapy from NIV.
- Copyright ©ERS 2015