Worldwide Clinical Practice of High-Flow Nasal Cannula and Concomitant Aerosol Therapy in the Adult ICU Setting

Autor: Lixin Xie, Meilien Tu, Armèle Dornelas de Andrade, Jie Li, Lingyue Gong, Lei Yang, Stephan Ehrmann, James B Fink, Chris Burtin, Guoqiang Jing
Přispěvatelé: Rush University [Chicago], Chang Gung University, Binzhou Medical University (MBBS), Partenaires INRAE, Universiteit Hasselt (UHasselt), Federal University of Pernambuco [Recife], Service de Médecine Intensive Réanimation [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre d'Etude des Pathologies Respiratoires (CEPR), UMR 1100. Equipe 3 'Aérosolthérapie et biothérapies à visée respiratoire' (CEPR. Equipe 3), Centre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100 (CEPR), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), CRICS-TRIGGERSEP, Li, Jie/0000-0003-0121-1291, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)
Rok vydání: 2021
Předmět:
Adult
Pulmonary and Respiratory Medicine
medicine.medical_specialty
medicine.medical_treatment
pulmonary aerosol delivery
Critical Care and Intensive Care Medicine
medicine.disease_cause
[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
030226 pharmacology & pharmacy
transnasal pulmonary aerosol delivery
Hypoxemia
Aerosol therapy
03 medical and health sciences
0302 clinical medicine
Oxygen therapy
Administration
Inhalation
medicine
Cannula
Humans
survey
Mouthpiece
Original Research
Aerosols
hypoxemia
business.industry
Oxygen Inhalation Therapy
030208 emergency & critical care medicine
General Medicine
High-flow nasal cannula
aerosol therapy
transnasal
Bronchodilator Agents
3. Good health
Clinical Practice
Intensive Care Units
Nebulizer
Concomitant
Emergency medicine
medicine.symptom
business
Nasal cannula
Zdroj: Respiratory Care
Respiratory Care, Daedalus Enterprises Inc, 2021, 66 (9), pp.1416-1424. ⟨10.4187/respcare.08996⟩
Respir Care
ISSN: 1943-3654
0020-1324
DOI: 10.4187/respcare.08996
Popis: BACKGROUND: High-flow nasal cannula (HFNC) oxygen therapy has been broadly used. However, no consensus has been achieved on the practical implementation of HFNC and how to provide aerosol delivery during HFNC therapy in adult patients. METHODS: An online anonymous questionnaire survey endorsed by 4 academic societies from America, Europe, mainland China, and Taiwan was administered from May to December 2019. Clinicians who had worked in adult ICUs for > 1 year and had used HFNC to treat patients within 30 days were included. RESULTS: A total of 2,279 participants clicked on the survey link, 1,358 respondents completed the HFNC section of the questionnaire, whereas 1,014 completed the whole survey. Postextubation hypoxemia and moderate hypoxemia were major indications for HFNC. The initial flow was mainly set at 40–50 L/min. Aerosol delivery via HFNC was used by 24% of the participants (248/1,014), 30% (74/248) of whom reported reducing flow during aerosol delivery. For the patients who required aerosol treatment during HFNC therapy, 40% of the participants (403/1,014) reported placing a nebulizer with a mask or mouthpiece while pursuing HFNC (a method shown to reduce inhaled dose), whereas 33% (331/1,014) discontinued HFNC to use conventional aerosol devices. A vibrating mesh nebulizer was the most commonly used nebulizer (40%) and was mainly placed at the inlet of the humidifier. CONCLUSIONS: The clinical utilization of HFNC was variable, as were indications, flow settings, and criteria for adjustment. Many practices associated with concomitant aerosol therapy were not consistent with available evidence for optimal use. More efforts are warranted to close the knowledge gap.
Databáze: OpenAIRE
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