High-flow nasal oxygenation for anesthetic management

Korean J Anesthesiol. 2019 Dec;72(6):527-547. doi: 10.4097/kja.19174. Epub 2019 Jun 5.

Abstract

High-flow nasal oxygenation (HFNO) is a promising new technique for anesthesiologists. The use of HFNO during the induction of anesthesia and during upper airway surgeries has been initiated, and its applications have been rapidly growing ever since. The advantages of this technique include its easy set-up, high tolerability, and its abilities to produce positive airway pressure and a high fraction of inspired oxygen and to influence the clearance of carbon dioxide to some extent. HFNO, via a nasal cannula, can provide oxygen both to patients who can breathe spontaneously and to those who are apneic; further, this technique does not interfere with bag-mask ventilation, attempts at laryngoscopy for tracheal intubation, and surgical procedures conducted in the airway. In this review, we describe the techniques associated with HFNO and the advantages and disadvantages of HFNO based on the current state of knowledge.

Keywords: Airway management; Airway surgery; Apneic oxygenation; Endotracheal intubation; High-flow nasal oxygenation; Hypercapnea; Hypoxemia.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Airway Management / methods*
  • Anesthesia, General / methods*
  • Cannula
  • Humans
  • Hypercapnia / etiology
  • Masks
  • Oxygen Inhalation Therapy / adverse effects
  • Oxygen Inhalation Therapy / methods*
  • Perioperative Care / methods
  • Rapid Sequence Induction and Intubation / methods
  • Respiratory System / surgery