The aim of this study was to describe the changes in respiratory rate, heart rate and dyspnea, before and after using HFNC in patients presenting to our emergency department with ARF.
A retrospective cohort study was performed. To all adults presenting to the emergency department who used high flow nasal cannula to treat clinical signs of acute respiratory failure based on the presence of a breathing frequency ≥ 25 breath/min and increase work of breathing evidence by dyspnea, in-drawing, accessory-muscle use and/or diaphoresis despite conventional oxygen therapy ≥ 6 l/min. Demographic variables and clinical and gasometric parameters before and after two hours using HFNC were recorded.
Study Type
OBSERVATIONAL
Enrollment
43
The high flow device that we used was an air oxygen blender (Whisper FlowⓇ), which allows FiO2 adjustment between 0.30 and 1.0 and can deliver a gas flow from 10 to 150 l/min. The gas mixture was routed from a heated humidifier (MR850 with MR 290 chamber) through a one line heated inspiratory circuit (RT241) to the subject at a temperature of 37°C via a nasal cannula (OptiflowⓇ).
Heart Rate
The closest value of Heart Rate before starting HFNC, and two hours later was collected from the electronic clinical history.
Time frame: 2 hours
Respiratory Rate
The closest value of Respiratory Rate before starting HFNC, and two hours later was collected from the electronic clinical history.
Time frame: 2 hours
Dyspnea
The closest value of Dyspnea (Modified Borg Dyspnea scale) before starting HFNC, and two hours later was collected from the electronic clinical history. The Modified Borg Dyspnea Scale is a rated numerical score used to measure dyspnea. This scale has a minimum value of 0 ( represent no dyspnea) and a maximum value of 10 (worse dyspnea).
Time frame: 2 hours
Initial HFNC setting
The gas flow rate and the fraction of inspired oxygen at the HFNC initiation of treatment were collected from the electronic clinical history.
Time frame: 2 hours
Acute respiratory failure etiology
Presence of a breathing frequency ≥ 25 breath/min and increase work of breathing evidence by dyspnea, in-drawing, accessory-muscle use and/or diaphoresis despite conventional oxygen therapy ≥ 6 l/min.
Time frame: 3 minutes
Average time of use the HFNC
The total hours of use of HFNC were collected from the electronic clinical history.
Time frame: until 28 days
Delay of HFNC treatment
The hours between the admission to HFNC initiation were collected from the electronic clinical history.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: until 24hs
Efficacy of HFNC treatment
When the patient did not need for escalation to other non-invasive or invasive ventilatory support.
Time frame: 28 days
Failure of HFNC treatment
When the patient need non-invasive or invasive ventilatory support or died. The type of ventilatory support post-failure were collected from the electronic clinical history.
Time frame: 28 days
Mortality rate at 28 day from ED admission
The number of patients who died after requiring HFNCO were collected from the electronic clinical history
Time frame: 28 days
Palliative Care
Consensus between patient and/or patient´s family and the physician about the care for the terminally ill patient, provided by an organized health service
Time frame: 28 days