Purpose: High flow nasal cannula (HFNC) is a relatively recent respiratory support technique which delivers high flow, heated and humidified controlled concentration of oxygen via the nasal route. Recently, its use has increased for a variety of clinical indications. To guide clinical practice, we developed evidence-based recommendations regarding use of HFNC in various clinical settings. Methods: We formed a guideline panel composed of clinicians, methodologists and experts in respiratory medicine. Using GRADE, the panel developed recommendations for four actionable questions. Results: The guideline panel made a strong recommendation for HFNC in hypoxemic respiratory failure compared to conventional oxygen therapy (COT) (moderate certainty), a conditional recommendation for HFNC following extubation (moderate certainty), no recommendation regarding HFNC in the peri-intubation period (moderate certainty), and a conditional recommendation for postoperative HFNC in high risk and/or obese patients following cardiac or thoracic surgery (moderate certainty). Conclusions: This clinical practice guideline synthesizes current best-evidence into four recommendations for HFNC use in patients with hypoxemic respiratory failure, following extubation, in the peri-intubation period, and postoperatively for bedside clinicians.
The role for high flow nasal cannula as a respiratory support strategy in adults : a clinical practice guideline / B. Rochwerg, S. Einav, D. Chaudhuri, J. Mancebo, T. Mauri, Y. Helviz, E.C. Goligher, S. Jaber, J.-. Ricard, N. Rittayamai, O. Roca, M. Antonelli, S.M. Maggiore, A. Demoule, C.L. Hodgson, A. Mercat, M.E. Wilcox, D. Granton, D. Wang, E. Azoulay, L. Ouanes-Besbes, G. Cinnella, M. Rauseo, C. Carvalho, A. Dessap-Mekontso, J. Fraser, J.-. Frat, C. Gomersall, G. Grasselli, G. Hernandez, S. Jog, A. Pesenti, E.D. Riviello, A.S. Slutsky, R.D. Stapleton, D. Talmor, A.W. Thille, L. Brochard, K.E.A. Burns. - In: INTENSIVE CARE MEDICINE. - ISSN 0342-4642. - 46:12(2020), pp. 2226-2237.
|Titolo:||The role for high flow nasal cannula as a respiratory support strategy in adults : a clinical practice guideline|
|Parole Chiave:||Extubation; High flow nasal cannula; Mortality; Peri-intubation; Postoperative; Respiratory failure|
|Settore Scientifico Disciplinare:||Settore MED/41 - Anestesiologia|
|Data di pubblicazione:||2020|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1007/s00134-020-06312-y|
|Appare nelle tipologie:||01 - Articolo su periodico|
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