[High-flow nasal cannula oxygen therapy in critical patients. Prospective study]

Abstract

Objective: To analyze the incidence of use of high-flow nasal cannula oxygen (HFNC) in intensive care and evaluate the procedure.

Basic procedures: descriptive prospective study.

Inclusion criteria: all participants were patients admitted to the intensive care units of the hospital Clínico San Carlos November 2012 - January 2013 that required HFNC.

Variables: socio-demographic; indications, complications, objectives and flows of the therapy. Statistical analysis with average, standard deviation and percentages, with the statistical program SPSS ver18.0.

Results: 12 cases of which 58.3% were men, with a mean age 68.66 (± 12) and with NEMS 33.25 (±7). The incidence of HFNC was 0.95%. The indication of HFNC was: 75% moderate respiratory failure or need for oxygen supply greater than 40%, 58.3% hypoxemia without hypercapnia, the 41.7% withdrawal and/or employment with non-invasive mechanical ventilation, the 25% support post-extubation, the 16.7% exacerbations of heart failure, the 16.7% improve respiratory work and the 8.3% acute lung edema. The main complications of the HFNC were: mouth-breathing (8.3%), nasal injury (8.3%) and abundant secretions (8.3%). In the fulfilment of the objectives of the HFNC, there was a 91.7% improvement of oxygen therapy, and in 50% of the cases orotracheal intubation was averted.

Conclusions: There is a low incidence of HFNC in the unit. The main indication is the moderate respiratory failure or the high need for oxygen supply. Almost all patients have improved with oxygen therapy, although it has not been possible to avoid intubation.

Keywords: Alto flujo; Critical care; Cuidados críticos; High flow; Insuficiencia respiratoria; Oxygen; Oxígeno; Respiratory insufficiency.