Title: HFNC for Apneic Oxygenation

Posted: 3/3/2015 by Mike Winters, MBA, MD

High-Flow Nasal Cannula for Apneic Oxygenation

In recent years, much has been written about the use of apneic oxygenation for patients who require endotracheal intubation (ETI).
Critically ill patients often have little cardiopulmonary reserve and can rapidly desaturate during ETI.
High-flow nasal cannula (HFNC) devices can deliver heated, humidified O2 up to 60 L/min and can provide a modest amount of positive pressure.
A recent study evaluated the use of a HFNC device for apneic oxygenation in ICU patients requiring ETI:
- Prospective, quasi-experimental, before-after study
- 101 patients in a single ICU in France
- Compared NRB + nasal cannula to HFNC for preoxygenation/apneic oxygenation
- Prevelance of severe hypoxemia (SpO2 < 80%) was significantly lower in the HFNC group
Clinical Application: Consider using HFNC for apneic oxygenation in critically ill patients with mild-to-moderate hypoxemia who require ETI.

References

Miguel-Montanes R, et al. Use of high-flow nasal cannula oxygen therapy to prevent desaturation during tracheal intubation of intensive care patients with mild-to-moderate hypoxemia. Crit Care Med 2015;43:574-83.