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High-Flow Oxygen Therapy: Non-Invasive Respiratory Support

Safeguarding High-Flow Oxygen Therapy

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. Especially high flow nasal cannula (HFNC) oxygen therapy can provide respiratory support for patients with acute hypoxemic respiratory failure and may help to prevent subsequent intubation.

In preterm infants high flow O2 therapy with HFNC has similar rates of efficacy to other forms of non-invasive respiratory support for preventing treatment failure, death and chronic lung disease (CLD).

Life-Saving Treatment...

High Flow Oxygen Therapy with DrägerPlay video

...with High-Flow Oxygen Therapy for All Patient Categories.

How can your patients benefit from the application of high-flow oxygen? When is the optimal time to use high-flow therapy? Watch our intro video to learn more!

High-Flow O2 therapy for neonates and pediatric patientsPlay video

High-Flow Oxygen Therapy for Neonates

See how early initiation of appropriate non-invasive respiratory support is the most important intervention to avoid mechanical ventilation.

High-Flow nasal oxygen therapy is the most widely applied intervention for the treatment of hypoxemic respiratory failure due to COVID-19.

Menga LS et al. Noninvasive respiratory support for acute respiratory failure due to COVID-19 Curr Opin. Crit Care. 2022 Feb

This is O2 Therapy

O2 therapy is suitable for use as respiratory support for adults, pediatric patients, and neonates who can inhale and exhale spontaneously. In O2 therapy, a set flow of heated and humidified breathing gas with a specified oxygen concentration is supplied to the patient. This continuous oxygen flow could be applied via oxygen masks or nasal cannulas.

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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 liters 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 liters per minute and is achieved by bubbling the gas through a container of sterile water.

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High-flow oxygen therapy is typically applied with a special binasal high-flow nasal cannula (HFNC) which is comfortable for the patient and can be used continuously for extended periods of time. The flow rates will be 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 airway pressure. HFNC is used with the application of heated and humidified blended air. This may prevent mucosal drying and associated disadvantages. It requires only a source of oxygen and compressed air as well as a heating/humidification system.

A growing body of evidence supports that HFNC can be used safely and effectively as an alternative to non-invasive therapies in NICU for term and pre-term infants following extubation.


Wilkinson D et al. High flow nasal cannula for respiratory support in preterm infants. Cochrane Database of Systematic Reviews 2016, Issue 2. Art. No.: CD006405. DOI: 10.1002/14651858.CD006405.pub3.

This is Safeguarding High-Flow Therapy

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By using Dräger ventilators you can conveniently switch your patient between traditional invasive ventilation to non-invasive ventilatory support or HFNC to meet changing needs all while still using the same device. This approach also supports you by the successful transition of patients on oxygen therapy to wean them/move them out of your ICU.

Due to the unsecured airways the safety of your patient during the application of high-flow oxygen is key and the overarching goal of lung protective ventilation starts already here. Therefore, a limitation of the maximum pressure with respective adaptation of the flow depending on the individual patient conditions is crucial.

Our O2 therapy function enables a Safeguarding High-Flow Oxygen Therapy as you have the possibility of a Pmax setting. A pos­sible exceeding of the set maximum allowed airway pressure is detected early, and the flow is reduced accordingly. This not only reduces the number of alarms, but also may help to increase your patients’ safety.

Ventilation Function Sheet (for Adult Patients)
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Ventilation Function Sheet (for Neonates and Paediatric Patients)
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Application Support

Make use of the comprehensive Dräger portfolio in your daily clinical work.

With our Dräger ventilators you can benefit from a smooth and seamless transition from O2 therapy through NIV to invasive ventilation and back. With our dedicated high-flow oxygen accessories, you could ensure the success of your treatment.

HI-Flow Star How to use Video (EN-Version, 2022)Play video

How to Use Hi-Flow Star

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

Quick Guide: High-Flow Star
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Quick Guide: Aquapor H300
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Learn More About Our High-Flow Oxygen Accessories

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Aquapor H300

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Hi-Flow Star

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Breathing Circuits

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Evidence

Do you want to get an overview about current publication and studies focusing on high-flow therapy? Check out our literature lists:

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Literature list High Flow for adults

High-flow nasal oxygen therapy reduced the need for non-invasive ventilation by 80%, reduced episodes of oxygen de-saturation by 66%, reduced the need for reintubation by 80%.8

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Literature List High Flow for Paediatric Patients

The mechanisms of actions of HFT are five-fold: HFT 1) flushes dead space of the nasopharyngeal cavity allowing for better ventilation as well as oxygenation, 2) provides a flow adequate to support inspiration therefore reducing inspiratory work of breathing, 3) improves lung and airway mechanics by eliminating the effects of drying/cooling, 4) reduces or eliminates the metabolic cost of gas conditioning, and 5) can be used to provide end distending pressure.9

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Customer Experiences

Dräger Evita ventilator 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.

Download report

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High-Flow Nasal O2 Therapy Used as an Alternative to CPAP and NIMV To Improve Comfort and Relieve Distress for Neonates

A premature infant on relatively high levels of CPAP following extubation in the NICU tolerated a heated high-flow nasal cannula (HFNC) better, resulting in reduced anxiety, lower respiratory distress, and improved gas exchange.

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Get in Touch With Your Specialist in Acute Care

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Sources

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

7Menga LS et al. Noninvasive respiratory support for acute respiratory failure due to COVID-19 Curr Opin. Crit Care. 2022 Feb

8SM. Maggiore, FA. Idone, R. Vaschetto, et al. “Nasal High-Flow vs Venturi Mask Oxygen Therapy after Extubation: Effects on Oxygenation, Comfort, and Clinical Outcome”, American Journal of Respiratory & Critical Care Medicine, 2014

9 Dysart K et al. Research in high flow therapy: mechanisms of action; VOLUME 103, ISSUE 10, P1400-1405, OCTOBER 01, 2009