High-flow nasal cannula oxygenation utilization in respiratory failure

Published:April 25, 2019DOI:


      • High flow nasal cannula is a respiratory device reaching flows of 25 to 60 L/min.
      • HFNC consists of a high flow generator, active air humidification and heating system.
      • Acute hypoxemic normocapnic respiratory failure is the main indication for HFNC.
      • HFNC may support several invasive diagnostic-therapeutic procedures.


      High flow nasal cannula (HFNC) represents a new oxygenation system to be used in the treatment of respiratory emergencies. During HFNC therapy, the active humidification and air heating system allow the patient to tolerate higher flows by favouring physiologic mucociliary clearance and improving fluidity of respiratory secretions. Following this, FiO2 values are more stable and reliable, by reducing losses and minimizing ambient air entrainment. Several clinical trials in acute respiratory failure patients have suggested lower rate of invasive mechanical ventilation, improved comfort and enhanced survival by early HFNC utilization in comparison with conventional oxygen therapy (COT) or non-invasive ventilation (NIV). This review aims to summarize the main evidences on the use of HFNC in the acute setting and its major indications.


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