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High flow nasal cannula (hfnc) by Tarfa Al-Sabhan
1. UNIVERSITY OF DAMMAM.
Collage Of Applied Medical Sciences.
Respiratory Care Department.
High flow nasal cannula (HFNC)
Tarfa Ahmed Al-Sabhan
Clinical instructor :Mr. Maher AlQuaimi
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What is high flow nasal cannula?!
Purposed and benefits.
Sitting and setup.
HFNC for adult.
HFNC for newborns and infants.
Indication and contraindication.
• Comparison between LFNC and HFNC.
3. • The high flow nasal cannula (HFNC) is a device used
to deliver fixed supplemental oxygen or airflow to a
patient or person in need of respiratory help
• high-flow nasal cannula (HFNC) oxygen therapy was
introduced, accompanied by heated humidification
systems to prevent the associated drying of upper
airway mucosa and to increase patient comfort.
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Delivery of optimally humidified and warm gases
Decreased work of breathing
Decreased body energy expenditure
Less problems with thickened secretions
Less problems with nasal irritation/septal damage
Patient comfort
Patient compliance
Optimized patient outcomes
5. • Vapotherm developed the 2000i High-Flow
Therapy system, which consisted of a
designated cannula with a heated
cartridge-type humidifier using membrane
technology for water vapor transfer.
• The Vapotherm 2000i was recalled in 2005
due to concerns of bacterial
contamination, but was reinstated after
manufacturing controls and
recommendations for use of only sterile
water, single-patient use, and disinfection
procedures.
6. • . The system uses a heated humidifier with
hot-plate and single-use water chamber,
similar to those for application for noninvasive
or invasive mechanical ventilation.
• A separate or combined air/O2 blender or airoxygen entrainment device and flow meter
provide oxygen.
• An oxygen analyzer is also required.
• Humidified gas mixtures exit the humidifier
through large bore corrugated tubing that
connects to the cannula.
9. • A delivery system to provide HFNC oxygen requires 3
components: a patient interface, a gas delivery device(s) to
control flow and FIO2, and a humidifier.
• Several manufacturers provide cannulas of similar style and
appearance, which are designated for high-flow applications.
• The Fisher & Paykel OptiFlow cannulas use a different design.
The nasal prongs are held in place on the upper lip with an
elastic over-ear head band
• They are available in large, medium, and small sizes
11. • The HFNC offers potential for improved oxygen delivery for a
majority of patients with moderate hypoxemic respiratory
failure.
• The HFNC can be adapted for use in a variety of clinical
settings (exercise lab, ED, and ICU).
• The physical exam findings of reduction in breathing
frequency can provide a reliable guide to predict improved
oxygenation, as well as treatment failures, in addition to SpO2
monitoring.
13. • As was mentioned previously, the clinical application of nasal
cannula oxygen with flow > 1 L/min applied to premature babies,
newborns, and pediatric patients had an earlier and slightly different
evolution than with adults.
• A number of patient interfaces were initially developed for NCPAP,
including head-hood or facial chamber, sealing face or nasal mask,
and long nasopharyngeal tube.
• Currently NCPAP is most commonly applied using short bi-nasal
pharyngeal prongs, with humidified gas source and circuit.
17. • Respiratory distress from bronchiolitis, pneumonia, congestive
heart failure, etc
• Respiratory support post extubation and mechanical ventilation
• Weaning therapy from mask CPAP or BIPAP
• Respiratory support to children with neuromuscular disease
• Apnoea of prematurity
19. HFNC
• More expensive(stand, blender/flow meter/analyzer,
humidifier, heated-wire circuit, and cannula)
• Fixed performance
• Use with heated humidifier.
LFNC
• Less expensive.
• Variable performance.
• Use with unheated bubble humidifier.