In clinical practice CPAP has the effect of ‘splinting open’ alveoli, improving ventilation/perfusion matching and subsequent oxygenation whilst also decreasing work of breathing and can stabilise the chest wall in the presence of chest wall trauma. Landmark studies also report the ability for higher flows to generate distending pressures similar to those achieved with continuous positive airway pressure (CPAP) (Groves 2007 Park et al. Over ten years ago HFOT devices were introduced with heated humidification systems allowing higher flow rates and oxygen concentrations, whilst minimising the effects of mucosal dryness and damage, enhancing patient comfort and tolerance (Ward 2016). With higher flow rates there appears to be even greater washout of anatomical dead space (Ward 2016). In adults, HFOT was initially recognised using flows of up to 40L/minute, showing that a higher fraction of inspired oxygen (FiO 2) could be achieved with higher flows compared to the same flows with other interfaces due to the nasopharynx and oropharynx acting as internal anatomic reservoirs that increase the volume of inhaled oxygen as well as a wash out of dead space in the nasal passage. Additionally, in current clinical practice when using nasal cannula with low flow rates, this is not used in conjunction with humidification (Nishimura 2015). It is widely accepted that caution should be exercised when using nasal cannula with oxygen flow rates over 5–6L/minute due to the risk of mucosal dryness and damage. However, limitations were also recognised in terms of nasal discomfort, dryness and the provision of only lower levels of inspired oxygen to the patient’s minute ventilation (Ward 2016). The advantages of this were soon recognised, enabling the patient to eat, drink and speak, as well as limiting the feelings of claustrophobia often felt with a tight-fitting face mask. Oxygen delivery via nasal cannula was first implemented in the early 1940s in order to direct flow into the nose. Recommendations for future work includes the collection of qualitative data on patient comfort and compliance with HFOT in addition to information on clinician confidence in setting up and weaning patients from the device. It also demonstrated that HFOT via Airvo™ can be safely implemented in ward settings for a variety of clinical conditions. In this report, clinical observations showed that for those patients who have secretion retention, atelectasis, increased work of breathing, and increasing oxygen requirements, HFOT is an appropriate treatment option especially in those patients who are not reliant on high levels of positive end expiratory pressure (PEEP). Data was collected on patient diagnosis, clinical indications, respiratory rate, oxygen percentage and mode of delivery prior to using high-flow, initial HFOT settings and highest settings throughout treatment, number of HFOT treatment days and clinical outcome. It was used on the critical care unit, but its use focused primarily at ward level to determine which patients could benefit from it and to indicate where it could be safely delivered. Independent control of flow, inspired oxygen and humidification, and reports of good patient tolerance, makes it a favourable treatment option.Ī service review looking at the use of HFOT delivered via Airvo™ (Fisher and Paykel) was completed over a six-month period in the acute clinical environment in a small tertiary hospital in New Zealand. It does not store any personal data.Since 2010 the benefits of high-flow oxygen therapy (HFOT) have been realised both in the acute clinical setting and for chronic long-term conditions. The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. The cookie is used to store the user consent for the cookies in the category "Performance". This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other. The cookies is used to store the user consent for the cookies in the category "Necessary". The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". The cookie is used to store the user consent for the cookies in the category "Analytics". These cookies ensure basic functionalities and security features of the website, anonymously. Necessary cookies are absolutely essential for the website to function properly.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |