Critical Care

, 16:P136 | Cite as

Nasal high-flow oxygen in patients with hypoxic respiratory failure: effect on functional and subjective respiratory parameters compared to conventional oxygen therapy and noninvasive ventilation

  • R Riessen
  • N Schwabbauer
  • B Berg
  • G Blumenstock
  • M Haap
  • J Hetzel
Poster presentation

Keywords

Global Rating Respiratory Parameter Noninvasive Ventilation Cardiogenic Pulmonary Edema Nasal Prong 

Introduction

This study compared a nasal high-flow oxygen therapy (NHFO2) with conventional oxygen therapy via a Venturi mask (VM) or noninvasive ventilation (NIV) in patients with hypoxic respiratory failure. Study endpoints were functional respiratory parameters, dyspnea, patient comfort and a global rating by the patients.

Methods

We included 14 patients with hypoxic respiratory failure (paO2 <55 mmHg under room air). Exclusion criteria were ventilatory failure, hemodynamic instability, cardiogenic pulmonary edema, NIV contraindications and inability to cooperate. Patients were treated in a randomized order for 30 minutes each with NHFO2 (Optiflow®; Fisher-Paykel), VM or NIV, using a FiO2 of 0.6. Every treatment phase was preceded by a 15-minute baseline phase in which the patients received oxygen via a standard nasal prong (SaO2 goal >88%). At the end of each treatment phase vital signs and blood gases were measured and patients rated their dyspnea and their general comfort on a 10-point scale. Finally, patients were ask for a global rating of all three devices ranging from 1 (very good) to 6 (failed) and could choose one device for further treatment.

Results

The paO2 was highest under NIV with 129 ± 38 mmHg, followed by NHFO2 (101 ± 34 mmHg, P < 0.01 vs. NIV) and VM (85 ± 21 mmHg, P < 0.001 vs. NIV, P < 0.01 vs. NHFO2, ANOVA). All other vital and blood gas parameters did not show significant differences. Dyspnea rating on a 10-point Borg scale was significantly better under NHFO2 (2.9 ± 2.1) and VM (3.3 ± 2.3) compared to NIV (5.0 ± 3.3) (P < 0.05, vs. NHFO2 or VM). Comfort rating showed similar results: NHFO2 2.7 ± 1.8; VM 3.1 ± 2.8; NIV 5.4 ± 3.1 (P < 0.05, NIV vs. NHFO2 or VM). In the final global rating using German school grades from 1 to 6 NHFO2 also received the best rating (2.3 ± 1.4), followed by VM (3.2 ± 1.7, P = NS vs. NHFO2) and NIV (4.5 ± 1.7, P < 0.01 vs. NHFO2 and P < 0.05 vs. VM). For further treatment 10 patients chose NHFO2, three VM and one NIV.

Conclusion

NHFO2 is a promising new device for oxygen supply in respiratory failure, offering better oxygenation than the VM and better patient comfort and tolerance than NIV.

Copyright information

© Riessen et al.; licensee BioMed Central Ltd. 2012

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Authors and Affiliations

  • R Riessen
    • 1
  • N Schwabbauer
    • 1
  • B Berg
    • 1
  • G Blumenstock
    • 1
  • M Haap
    • 1
  • J Hetzel
    • 1
  1. 1.University Hospital TübingenGermany

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