Korean J Anesthesiol.  2019 Dec;72(6):610-613. 10.4097/kja.d.18.00368.

Postoperative use of high flow nasal insufflation for obstructive sleep apnea: a case series

Affiliations
  • 1Department of Anesthesia and Surgical Intensive Care, Surgery and Science, Changi General Hospital, Singapore, Singapore. avinash_gobindram@singhealth.com.sg
  • 2Department of Sleep Medicine, Surgery and Science, Changi General Hospital, Singapore, Singapore.

Abstract

BACKGROUND
Continuous positive airway pressure (CPAP) therapy is the gold standard treatment for obstructive sleep apnea (OSA), although, associated with poor patient compliance. Conversely, high flow, humidified, temperature-regulated nasal insufflation of oxygen or air is well tolerated. CASE: We describe our experience of three patients with known or suspected moderate to severe OSA who were poorly compliant to CPAP therapy and received high flow nasal insufflation (HFNI) postoperatively. None had significant episodes of desaturation (SpOâ‚‚< 95%) and all patients uniformly reported superior comfort levels than with the CPAP therapy. HFNI generates small amounts of positive end-expiratory pharyngeal pressure, increases inspiratory airflow and decreases dead space ventilation. Due to the open system, less difficulty with the patient-mask interface and improved patient comfort is experienced. These factors help prevent hypopnea and lead to enhanced sleep continuity.
CONCLUSIONS
HFNI may be a promising alternative to CPAP therapy in the perioperative setting.

Keyword

Continuous positive airway pressure; High flow nasal oxygen; Hypopnea; Obstructive sleep apnea; Optiflow; Respiratory distress index; STOP-Bang Score

MeSH Terms

Continuous Positive Airway Pressure
Humans
Insufflation*
Oxygen
Patient Compliance
Sleep Apnea, Obstructive*
Ventilation
Oxygen
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