CONTINUOUS CONTROLLED HUMIDIFICATION OF INSPIRED AIR

doi:10.1016/S0140-6736(68)91695-4

The Lancet

Volume 292, Issue 7580, 7 December 1968, Pages 1214-1216

https://doi.org/10.1016/S0140-6736(68)91695-4 Get rights and content

Abstract

It has been observed that gases can be administered through the nose at high flow-rates provided that they are at body-temperature and fully saturated with water-vapour. A simple and easily portable system has been devised for delivering gases in this way, and has been shown to be effective in volunteers. It is now proving satisfactory in clinical use, both for continuous humidification and for administration of oxygen.

References (1)

I.E. Cushing et al.

Cited by (14)

High-flow nasal cannula oxygen therapy in acute hypoxemic respiratory failure and COVID-19-related respiratory failure
2023, Journal of Intensive Medicine
Citation Excerpt :
NIV through continuous positive airway pressure (CPAP) or applied with pressure support (PS) was developed <10 years later[3] and has been widely used, based on a strong level of evidence, in cardiogenic pulmonary edema and chronic obstructive pulmonary disease exacerbations; however, it is not recommended in acute hypoxemic respiratory failure.[4] HFNC was first described in 1968[5] and can be considered a non-invasive oxygen support according to its physiological effects.[6–8] Since the 2010s, its use has spread among adult patients with acute hypoxemic respiratory failure, after first being used in preterm neonates and pediatric care.
Although standard oxygen face masks are first-line therapy for patients with acute hypoxemic respiratory failure, high-flow nasal cannula oxygen therapy has gained major popularity in intensive care units. The physiological effects of high-flow oxygen counterbalance the physiological consequences of acute hypoxemic respiratory failure by lessening the deleterious effects of intense and prolonged inspiratory efforts generated by patients. Its simplicity of application for physicians and nurses and its comfort for patients are other arguments for its use in this setting. Although clinical studies have reported a decreased risk of intubation with high-flow oxygen compared with standard oxygen, its survival benefit is uncertain. A more precise definition of acute hypoxemic respiratory failure, including a classification of severity based on oxygenation levels, is needed to better compare the efficiencies of different non-invasive oxygenation support methods (standard oxygen, high-flow oxygen, and non-invasive ventilation). Additionally, the respective role of each non-invasive oxygenation support method needs to be established through further clinical trials in acute hypoxemic respiratory failure, especially in severe forms.
Home High-Flow Oxygen Therapy Should Be Considered in Patients With COPD and Chronic Respiratory Failure
2023, Archivos de Bronconeumologia
High-flow nasal oxygen in acute hypoxemic respiratory failure
2022, Revue des Maladies Respiratoires
Bien que l’oxygénothérapie conventionnelle soit le traitement de première intention dans l’insuffisance respiratoire aiguë hypoxémique, l’oxygénothérapie à haut débit nasal a gagné une importante popularité dans les services de réanimation, grâce à sa simplicité d’utilisation et son efficacité pour améliorer l’oxygénation. Ses effets physiologiques sont capables de limiter les conséquences de l’insuffisance respiratoire aiguë hypoxémique et devraient atténuer les effets délétères des efforts inspiratoires intenses et prolongés générés par le patient. Bien que des études cliniques aient rapporté une diminution du risque d’intubation avec l’oxygénothérapie à haut débit nasal comparativement à l’oxygénothérapie conventionnelle, ses bénéfices sur la survie sont incertains. Cependant, il est nécessaire d’établir une définition de l’insuffisance respiratoire aiguë hypoxémique plus précise et adaptée aux essais cliniques avec une classification des niveaux de gravité basée sur le niveau d’oxygénation, afin de mieux comparer l’efficacité des différents supports non invasifs d’oxygénation (oxygénothérapie conventionnelle, à haut débit nasal et ventilation non invasive). Ainsi, d’autres essais cliniques sont nécessaires pour confirmer la place et le bénéfice des différents supports d’oxygénation, en particulier l’oxygénothérapie à haut débit nasal dans les formes les plus sévères d’insuffisance respiratoire aiguë hypoxémique.
Although standard oxygen is the first-line therapy in patients with acute hypoxemic respiratory failure, high-flow nasal oxygen has gained major popularity in ICUs due to its simplicity of application, good comfort for patients, and efficiency in improving oxygenation. Physiological effects of high-flow oxygen therapy can limit the physiological consequences of acute hypoxemic respiratory failure and may mitigate the deleterious effects of high and prolonged inspiratory efforts generated by patients. Although clinical studies have reported a decreased risk of intubation with high-flow oxygen therapy as compared with conventional oxygen therapy, its benefits with regard to survival are uncertain. However, a more precise definition of acute hypoxemic respiratory failure including a classification of severity levels based on oxygenation levels is needed, the objective being to better compare the efficiency of different non-invasive oxygenation supports (conventional oxygen therapy, high-flow oxygen and non-invasive ventilation). Moreover, other clinical trials are needed to confirm the place and the benefit of these oxygenation supports, particularly high-flow nasal oxygen therapy, in acute hypoxemic respiratory failure, especially in the severe forms.
Flow Wave Interpretation of High-Flow Nasal Cannula
2022, Open Respiratory Archives
The role of high flow oxygen therapy in acute respiratory failure
2015, Medicina Intensiva
La insuficiencia respiratoria aguda supone una de las causas más frecuentes de ingreso en los servicios de Medicina Intensiva y la oxigenoterapia sigue constituyendo una terapéutica de primera línea en el manejo de estos pacientes. En los últimos años, la oxigenoterapia de alto flujo ha sido descrita como una alternativa útil a la oxigenoterapia convencional en los pacientes con insuficiencia respiratoria aguda. La oxigenoterapia de alto flujo permite administrar un flujo de gas totalmente acondicionado hasta a 60 L/min mediante cánulas nasales, obteniendo una rápida mejoría de los síntomas debido a diferentes mecanismos como, por ejemplo, una reducción de la resistencia de la vía aérea superior, cambios en el volumen circulante y la generación de cierto grado de presión positiva. Además, todo ello se consigue junto con una mejor tolerancia y comodidad por parte del paciente. Sin embargo, la experiencia en adultos es todavía limitada y no existen guías clínicas que establezcan recomendaciones para su uso. En este artículo se pretende revisar la evidencia existente sobre el uso de oxigenoterapia de alto flujo en pacientes adultos con insuficiencia respiratoria aguda, así como sus posibles aplicaciones, ventajas y limitaciones.
Acute respiratory failure represents one of the most common causes of intensive care unit admission and oxygen therapy remains the first-line therapy in the management of these patients. In recent years, high-flow oxygen via nasal cannula has been described as a useful alternative to conventional oxygen therapy in patients with acute respiratory failure. High-flow oxygen via nasal cannula rapidly alleviates symptoms of acute respiratory failure and improves oxygenation by several mechanisms, including dead space washout, reduction in oxygen dilution and inspiratory nasopharyngeal resistance, a moderate positive airway pressure effect that may generate alveolar recruitment and an overall greater tolerance and comfort with the interface and the heated and humidified inspired gases. However, the experience in adults is still limited and there are no clinical guidelines to establish recommendations for their use. This article aims to review the existing evidence on the use of high-flow oxygen via nasal cannula in adults with acute respiratory failure and its possible applications, advantages and limitations.
Noninvasive Oxygenation in Patients with Acute Respiratory Failure: Current Perspectives
2022, International Journal of General Medicine

View all citing articles on Scopus

View full text

Preliminary CommunicationsCONTINUOUS CONTROLLED HUMIDIFICATION OF INSPIRED AIR

Abstract

Preliminary Communications
CONTINUOUS CONTROLLED HUMIDIFICATION OF INSPIRED AIR