J Korean Med Assoc.  2022 Mar;65(3):131-143. 10.5124/jkma.2022.65.3.131.

Treatment of acute respiratory failure: high-flow nasal cannula

• Park S

• KMID: 2527353
• DOI: http://doi.org/10.5124/jkma.2022.65.3.131

Abstract

Background
High-flow nasal cannulas (HFNCs) have recently been used for several conditions, such as hypoxemic respiratory failure, hypercapnic respiratory failure, post-extubation respiratory failure, and preintubation oxygenation, in critically ill patients.
Current Concepts
The advantages of HFNC compared with those of low-flow oxygen systems or noninvasive ventilation include enhanced comfort, increased humidification of secretions to facilitate expectoration, washout of the nasopharyngeal dead space to improve ventilation efficiency, provisioning for low positive end-inspiratory pressure effect, and fixed and rapid delivery of accurate fraction of inspired oxygen by minimizing the entrainment of room air. However, the indications are not absolute, with much of the proven benefit being subjective and physiologic.
Discussion and Conclusion
The goal of this review is to discuss the practical application and clinical uses of HFNCs in patients with acute respiratory failure, highlighting its unique respiratory and physiologic effects, device settings, and clinical indications.

Keyword

Nasal cannula; Oxygen inhalation therapies; Respiratory failure; 코삽입관; 산소흡입치료; 호흡부전