High Flow Nasal Cannula Oxygen in Acute Respiratory Failure; Effectiveness and Predictors of Failure

Abstract

Introduction: To determine the effectiveness of high flow nasal cannula (HFNC), and the factors predicting from failure of HFNC in acute respiratory failure. Method(s): We retrospectively evaluated acute respiratory failure patients who required HFNC at Chuncheon Sacred Hospital, between August 2011 and January 2012. Result(s): In all, 33 patients were included in the study. Their median age was 73.4 years (49-89). Majority of the patients were male(22 patients, 67%). The most common cause of acute respiratory failure was pneumonia followed by COPD acute exacerbation, acute pulmonary edema due to congestive heart failure, cancer progression, and lung fibrosis. The hospital mortality was 24%. In the unadjusted model, (P=0.03), APACHE II score (P=0.04), BNP (P=0.03) and higher respiratory rate (P= 0.04) were associated with HFNC failure. However, in the adjusted model, higher respiratory rate (P= 0.04) were associated with HFNC failure [P= 0.04, OR 3.36]. Conclusion(s): HFNC has beneficial effect on clinical sign and oxygenation in ICU patients with acute respiratory failure. Predictors of high flow nasal cannula failure might be used to guide decisions regarding intubation.