- Patients with acute hypoxemic respiratory failure in the emergency department (ED) experienced more short-term symptom and respiratory improvement after high-flow nasal cannula oxygen therapy (HFNC) than after standard therapy.
- Randomized trial needed.
Why this matters
- HFNC offers positive pressure in upper airway, positive end-expiratory pressure effect, and continuous washout of upper-airway dead space.
- It is understudied in this population.
- HFNC vs standard oxygen:
- Improved respiratory status at hour 1: 61% (33/54 patients) vs 15% (7/48 patients; P<.001>
- Oxygenation improvement by PaO2 of 31 (interquartile range, 0-67) mmHg vs 9 (9-36) mmHg 1 hour after treatment initiation (P=.02).
- Dyspnea: 92% (44/48) vs 56% (20/36; P<.01>
- 2-center prospective before-after study (n=102).
- Participants presented to EDs in acute hypoxemic respiratory failure.
- During first 6-month period, treatment was standard oxygen; in second 11-month period, it was HFNC.
- Outcome: proportion with improved respiratory status 1 hour after treatment initiation (≤25 breaths/minute without increased effort).
- Funding: None disclosed.
- Patients with cardiogenic pulmonary edema or chronic lung disease exacerbation were excluded.
- Most patients had community-acquired pneumonia.