High-Flow Oxygen Therapy: Non-Invasive Respiratory Support - Caregiver places HI-Flow Star cannula to deliver high-flow oxygen therapy

High-Flow Oxygen Therapy: Non-Invasive Respiratory Support

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High-flow oxygen therapy is non-invasive respiratory support that delivers warmed, humidified, oxygen-enriched air to patients. It is typically used for spontaneously breathing patients who require oxygen at higher flow rates. High-flow oxygen therapy can provide respiratory support for patients with acute hypoxemic respiratory failure and can also prevent subsequent intubation. It leads to improvements in oxygenation1, respiratory rate2, dyspnea3 and patient comfort4 and helps patients recover faster following extubation1,2. This translates to improved outcomes and shorter ICU stays4. This type of o2 therapy is also economical, as it does not necessarily require a ventilator, and can be used across different hospital departments.

Life-saving treatment with high-flow oxygen therapy

Take a look at how high-flow oxygen therapy can effectively be used to avoid both conventional mask-based non-invasive and invasive therapy in patients with compromised respiratory function.
HI-Flow Star nasal cannula being placed

High-flow oxygen therapy for spontaneously breathing patients

High-flow oxygen therapy is applied with a special binasal high-flow nasal cannula (HFNC), and a heated inspiratory breathing circuit. It is used for the application of heated and humidified blended air and oxygen at high flow rates, typically set between 30 l/min and 50 l/min. This high flow can provide more constant inspiratory oxygen concentrations than conventional oxygen therapy and can also generate some positive end expiratory pressure. HFNC systems are also used to wash out expired CO2 from the inspiratory dead space in the airways with oxygen enriched gas5. High-flow oxygen therapy can effectively be used to treat patients with mild to moderate levels of hypoxemic respiratory failure. As a preventive measure against post-extubation respiratory failure, high-flow cannulas have shown to be effective and consistently be better tolerated then NIV therapy6.

Patient is ventilated with ClassicStar NIV full-face mask

Conventional oxygen therapy is the administration of oxygen at a greater concentration than found in ambient air in order to treat or prevent the symptoms and manifestations of hypoxia. It uses nasal prongs or masks and has a maximum effective flow of approximately ten litres per minute. At this rate, no significant increase in expiratory pressure can be attained. To prevent mucosa from drying out, humidification of the gas stream is generally recommended at flow rates that exceed two litres per minute and is achieved by bubbling the gas through a container of sterile water.

Patient is ventilated with NovaStar NIV mask

CPAP (Continuous Positive Airway Pressure) therapy can also involve the use of a tight-fitting facial interface. Gas flow rates are not as high as with high-flow oxygen therapy. PEEP (Positive End Expiratory Pressure) is maintained through the seal between the face and the interface, which fits over the nose or the nose and mouth. The somewhat tightly fitting mask can produce discomfort and/or anxiety in some patients, and there is an increased risk of aspiration. This therapy requires either an NIV-capable ventilator or a dedicated CPAP therapy device.

Patient receives high-flow oxygen therapy with HI-Flow Star

High-flow oxygen therapy uses a nasal cannula that is more comfortable for the patient and can be used continuously for extended periods of time. The gas stream is humidified and heated in a controlled fashion. This prevents mucosal drying and associated disadvantages. It requires only a source of oxygen and compressed air as well as a heating/humidification system.

Dräger Evita ventilator case study

Case study: using Dräger Evita® ventilators to their full potential

In 2014, Glenfield Hospital, part of University Hospitals Leicester, changed its approach to using the Dräger Evita. Take a look at how this enabled improved cost efficiencies, patient comfort and ease of use for caregivers – contributing to a seamless care pathway.

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“As in most intensive care units, we are always interested in weaning our patients as soon as possible and have had a policy of weaning from invasive ventilation to non-invasive and then on to high-flow oxygen therapy for some patients.”

Vicky Chamberlain, Critical Care Technician, Glenfield Hospital, Leicester, UK

How to use the HI-Flow Star

Learn how to use the Dräger HI-Flow Star nasal oxygen delivery system with an oxygen blender and a ventilator.

Suggested downloads

Integrated oxygen therapy for respiratory care
Integrated oxygen therapy paper

Read about the recent trends in the use of high-flow oxygen therapy that has shown benefits in improved oxygenation, post extubation, improved lung volumes, patient comfort and tolerance.

A quick start guide
HI-Flow Star quick start guide

Get started fast: learn how to connect the Dräger HI-Flow Star inspiratory hose to a blender or ventilator.

Literature list
High-flow oxygen therapy literature list

Want to know more on high-flow oxygen therapy? Here’s a list for further reading.

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1 Improvements in oxygenation
Corley 2011; Parke 2009; Roca 2010; Sztrymf 2011; Sztrymf 2011a

2 Respiratory rate
Corley 2011; Roca 2010; Sztrymf 2011; Sztrymf 2011a

3 Dyspnoea
Corley 2011; Roca 2010; Sztrymf 2011

4 Patient comfort
Corley 2011; Roca 2010; Tiruvoipati 2010

5 Itagaki T, Okuda N, Tsunano Y, et al. Effect of high-flow nasal cannula on thoraco-abdominal synchrony in adult critically ill patients. Respir Care. 2014;59:70–4

6 Helviz, Y., Einav, S., A Systematic Review of the High-flow Nasal Cannula for Adult Patients, Critical Care2018 22:71