ERS Clinical Practice Guidelines: high-flow nasal cannula in acute respiratory failure.

Oczkowski, Simon; Ergan, Begüm; Bos, Lieuwe; Chatwin, Michelle; Ferrer, Miguel; Gregoretti, Cesare; Heunks, Leo; Frat, Jean-Pierre; Longhini, Federico; Nava, Stefano; Navalesi, Paolo; Uğurlu, Aylin Ozsancak; Pisani, Lara; Renda, Teresa; Thille, Arnaud W; Winck, João Carlos; Windisch, Wolfram; Tonia, Thomy; Boyd, Jeanette; Sotgiu, Giovanni; ... (2022). ERS Clinical Practice Guidelines: high-flow nasal cannula in acute respiratory failure. European respiratory journal, 59(4), p. 2101574. European Respiratory Society 10.1183/13993003.01574-2021

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BACKGROUND

High-flow nasal cannula (HFNC) has become a frequently used non-invasive form of respiratory support in acute settings, however evidence supporting its use has only recently emerged. These guidelines provide evidence-based recommendations for the use of HFNC alongside other noninvasive forms of respiratory support in adults with acute respiratory failure (ARF).

MATERIALS AND METHODOLOGY

The European Respiratory Society Task Force panel included expert clinicians and methodologists in pulmonology and intensive care medicine. The Task Force used the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methods to summarise evidence and develop clinical recommendations for the use of HFNC alongside conventional oxygen therapy (COT) and non-invasive ventilation (NIV) for the management of adults in acute settings with ARF.

RESULTS

The Task Force developed 8 conditional recommendations, suggesting using: 1) HFNC over COT in hypoxemic ARF, 2) HFNC over NIV in hypoxemic ARF, 3)HFNC over COT during breaks from NIV, 4) either HFNC or COT in post-operative patients at low risk of pulmonary complications, 5) either HFNC or NIV in post-operative patients at high risk of pulmonary complications, 6) HFNC over COT in non-surgical patients at low risk of extubation failure, 7) NIV over HFNC for patients at high risk of extubation failure unless there are relative or absolute contraindications to NIV, 8) trialling NIV prior to use of HFNC in patients with chronic obstructive pulmonary disease (COPD) and hypercapnic ARF.

CONCLUSIONS

HFNC is a valuable intervention in adults with ARF. These conditional recommendations can assist clinicians in choosing the most appropriate form of non-invasive respiratory support to provide to patients in different acute settings.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Tonia, Thomai

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0903-1936

Publisher:

European Respiratory Society

Language:

English

Submitter:

Beatrice Minder Wyssmann

Date Deposited:

22 Oct 2021 12:07

Last Modified:

16 Apr 2023 00:25

Publisher DOI:

10.1183/13993003.01574-2021

PubMed ID:

34649974

Additional Information:

Simon Oczkowski and Begüm Ergan act as co-first authors
Task force report

BORIS DOI:

10.48350/160267

URI:

https://boris.unibe.ch/id/eprint/160267

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