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Heated humidified high-flow therapy

High-flow therapy
Intervention
HFT diagram.png
Illustration of a patient using HFT device
ICD-10-PCS Z99.81
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Heated humidified high-flow (HHHF) therapy is a type of respiratory support method that delivers a high flow (liters per minute) of medical gas to a patient through an interface (nasal cannulae) intended to create a wash-out of the upper airway. The applied gas is heated to best match human body temperature (37 Celsius) and humidified targeting ideal body saturation vapor pressure.

High-flow therapy is useful in patients that are spontaneously breathing but have an increased work of breathing. Conditions such as general respiratory failure, asthma exacerbation, COPD exacerbation, bronchiolitis, pneumonia, and congestive heart failure are all possible situations where high-flow therapy may be indicated.

High-flow therapy has shown to be useful in neonatal intensive care settings for premature infants with Infant respiratory distress syndrome, as it prevents many infants from needing artificial ventilation via intubation, and allows safe respiratory management at lower FiO2 levels, and thus reduces the risk of retinopathy of prematurity and oxygen toxicity.

Due to the decreased stress of effort needed to breathe, the neonatal body is able to spend more time utilizing metabolic efforts elsewhere, which causes decreased days on a mechanical ventilator, faster weight gain, and overall decreased hospital stay entirely.

High flow therapy has been successfully implemented in infants and older children. The cannula improves the respiratory distress, the oxygen saturation, and the patient's comfort. Its mechanism of action is the application of mild positive airway pressure and lung volume recruitment.

HFT, the clinician can deliver higher FiO2 to the patient than is possible with typical oxygen delivery therapy without the use of a non-rebreather mask or tracheal intubation. Heated humidification of the respiratory gas facilitates secretion clearance and decreases the development of bronchial hyper-response symptoms. Some patients requiring respiratory support for bronchospasm benefit using air delivered by HFT without additional oxygen. HFT is useful in the treatment of sleep apnea. During use of HFT the patient can speak. Most patients find HFT more comfortable than using oxygen masks. As this is a non-invasive therapy, it avoids the risk of ventilator-associated pneumonia in situations where it can supplant the use of a ventilator.


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