Review
Biochemistry & Molecular Biology
Annamaria Venanzi, Paola Di Filippo, Chiara Santagata, Sabrina Di Pillo, Francesco Chiarelli, Marina Attanasi
Summary: High-flow nasal cannula (HFNC) therapy has gained interest as a valid alternative to nasal continuous positive airway pressure (nCPAP) in children with respiratory failure. Despite its wide use in clinical practice, there is a lack of guidelines to standardize the use of HFNC. This review aims to summarize the current knowledge about HFNC in children and propose a clinical practices algorithm for respiratory failure.
Review
Medicine, General & Internal
Santi Nolasco, Sara Manti, Salvatore Leonardi, Carlo Vancheri, Lucia Spicuzza
Summary: High-flow nasal cannula (HFNC) oxygen therapy is widely used in pediatric care due to its ease of use and safety, allowing for regulation of gas flow and temperature. HFNC have various physiological effects, including delivery of oxygen, positive end-expiratory pressure, reduction of work of breathing and clearance of dead space.
FRONTIERS IN MEDICINE
(2022)
Review
Respiratory System
Xiaoyang Zhou, Jiequan Liu, Jianneng Pan, Zhaojun Xu, Jianfei Xu
Summary: In pneumonia patients with acute hypoxemic respiratory failure (AHRF), measuring the respiratory rate-oxygenation (ROX) index within 12 hours of HFNC initiation can effectively predict the likelihood of successful weaning from HFNC. The range of 4.2-5.4 may represent the optimal confidence interval for predicting HFNC outcomes.
BMC PULMONARY MEDICINE
(2022)
Review
Respiratory System
Zhen Junhai, Yan Jing, Cao Beibei, Li Li
Summary: This study investigated the potential predictive value of the ROX index in determining the outcome of high flow nasal cannula therapy in patients with acute hypoxemic respiratory failure. The results indicate that the ROX index can serve as a novel marker to identify patients at higher risk of HFNC failure, although further research is needed to establish the optimal cut-off value and acquisition time. Subgroup analyses also revealed that the ROX index performs better in predicting HFNC failure in COVID-19 patients.
RESPIRATORY RESEARCH
(2022)
Review
Emergency Medicine
Brit Long, Stephen Y. Liang, Skyler Lentz
Summary: HFNC is a promising noninvasive ventilation system for adult patients with acute hypoxemic respiratory failure in the emergency department, providing warm, humidified oxygen at high flows with reliable FiO(2). Recent literature has shown efficacy in various conditions, including COVID-19, with reduced intubation, length of stay, and mortality in some cases.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Review
Critical Care Medicine
N. Ovtcharenko, E. Ho, W. Alhazzani, A. Cortegiani, B. Ergan, R. Scala, G. Sotgiu, D. Chaudhuri, S. Oczkowski, K. Lewis
Summary: The current evidence suggests that in patients with acute hypercapnic respiratory failure, HFNC is not significantly more effective than NIV in reducing mortality, intubation rates, or hospital length of stay, and there is no difference in carbon dioxide pressure change between the two treatments.
Article
Critical Care Medicine
Virginie Lemiale, Guillaume Dumas, Alexandre Demoule, Frederic Pene, Achille Kouatchet, Magali Bisbal, Saad Nseir, Laurent Argaud, Loay Kontar, Kada Klouche, Francois Barbier, Amelie Seguin, Guillaume Louis, Jean-Michel Constantin, Julien Mayaux, Florent Wallet, Vincent Peigne, Christophe Girault, Johanna Oziel, Martine Nyunga, Nicolas Terzi, Lila Bouadma, Alexandre Lautrette, Naike Bige, Jean-Herle Raphalen, Laurent Papazian, Fabrice Bruneel, Christine Lebert, Dominique Benoit, Anne-Pascale Meert, Samir Jaber, Djamel Mokart, Michael Darmon, Elie Azoulay
Summary: A ROX index greater than 4.88 appears to have a poor ability to predict intubation in immunocompromised patients with acute respiratory failure, although it remains highly associated with the risk of intubation and may be useful to stratify such risk in future studies.
ANNALS OF INTENSIVE CARE
(2021)
Article
Medicine, General & Internal
Federico Lionello, Francesco Lapia, Beatrice Molena, Andrea Padoan, Sara Lococo, Giovanna Arcaro, Gabriella Guarnieri, Andrea Vianello
Summary: The study aimed to investigate the safety profile of High-Flow Nasal Cannula (HFNC) in Neuromuscular Disease (NMD) patients intolerant to Non-Invasive Ventilation (NIV) for Acute Respiratory Failure (ARF). The results showed that HFNC used during the daytime alongside nocturnal NIV appeared to be a safe therapeutic approach for ARF patients with NMD. However, continuous use of HFNC was associated with an increased risk of treatment failure.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Mathematics, Interdisciplinary Applications
Jingen Xia, Jiaqi Chang, Jixiang Liang, Yixuan Wang, Na Wang
Summary: This paper used finite element simulation to analyze the impact of HFNC machine on upper respiratory tract under different flow and oxygen concentration, guiding professionals to adjust parameters appropriately. The study explored the complex environment of human respiratory tract and ventilation airflow, explaining some clinical phenomena using mathematical tools.
Article
Critical Care Medicine
Douglas Slobod, Elena Spinelli, Stefania Crotti, Alfredo Lissoni, Alessandro Galazzi, Giacomo Grasselli, Tommaso Mauri
Summary: The study found that using an asymmetrical high flow nasal cannula (HFNC) interface can reduce the work of breathing and improve ventilatory efficiency in patients with mild-to-moderate hypoxemic respiratory failure. However, it does not have a significant impact on oxygenation, lung mechanics, or alveolar recruitment.
Article
Emergency Medicine
Muhammad Khidir Mohd Kamil, Khadijah Poh Yuen Yoong, Abdul Muhaimin Noor Azhar, Aida Bustam, Ahmad Hariz Abdullah, Mohd Hafyzuddin Md Yusuf, Aliyah Zambri, Ahmad Zulkarnain Ahmad Zahedi, Hidayah Shafie
Summary: This study compared the effectiveness of non-rebreather mask combined with low-flow nasal cannula (NRB + NC) versus high-flow nasal cannula (HFNC) in improving oxygenation in patients with COVID-19-related hypoxemic respiratory failure (HRF). The results showed that HFNC may be beneficial for COVID-19 HRF, while NRB + NC is a viable alternative. Further randomized controlled trials are needed to evaluate the effectiveness of NRB + NC.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2023)
Article
Emergency Medicine
Muhammad Khidir Mohd Kamil, Khadijah Poh Yuen Yoong, Abdul Muhaimin Noor Azhar, Aida Bustam, Ahmad Hariz Abdullah, Mohd Hafyzuddin Md Yusuf, Aliyah Zambri, Ahmad Zulkarnain Ahmad Zahedi, Hidayah Shafie
Summary: This study retrospectively analyzed the effectiveness of non-rebreather mask combined with low-flow nasal cannula (NRB + NC) compared to high-flow nasal cannula (HFNC) in improving oxygenation in patients with COVID-19-related hypoxemic respiratory failure (HRF). The results showed significant improvements in oxygenation in both NRB + NC and HFNC groups. There were no significant differences in long-term outcomes between the two groups.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Santos Ferrer, Jesus Sancho, Irene Bocigas, Enric Bures, Heidi Mora, Erik Monclou, Alba Mulet, Antonio Quezada, Pablo Royo, Jaime Signes-Costa
Summary: The study showed that using the ROX index to predict the success of HFNC therapy in patients with ARF caused by SARS-CoV-2 pneumonia is feasible. The ROX index at 24 hours is the best predictor of HFNC success.
RESPIRATORY MEDICINE
(2021)
Review
Biology
Cheng-Wei Liu, Shih-Lung Cheng
Summary: This narrative review provides an overview of recent studies on the use of high-flow nasal cannula (HFNC) in patients with COVID-19-related acute hypoxemic respiratory failure. The review discusses the probability of successful use of HFNC in these patients, the impact of delayed intubation on mortality, the availability of convenient and accurate monitoring tools, comparison of HFNC with other types of noninvasive respiratory support, the clinical usefulness of combining HFNC with the prone position, and strategies to reduce infection risk associated with HFNC.
Article
Medicine, General & Internal
Amy H. Attaway, Jihane Faress, Frank Jacono, Srinivasan Dasarathy
Summary: The study revealed that increasing oxygen fraction without adjusting flow rate may exacerbate hypercapnia in COPD patients. Therefore, careful titration of oxygen therapy is essential, especially in COPD patients with baseline hypercapnia.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Critical Care Medicine
Judith Marin-Corral, Sergi Pascual-Guardia, Francesco Amati, Stefano Aliberti, Joan R. Masclans, Nilam Soni, Alejandro Rodriguez, Oriol Sibila, Francisco Sanz, Giovanni Sotgiu, Antonio Anzueto, Katerina Dimakou, Roberta Petrino, Ewoudt van de Garde, Marcos I. Restrepo
Summary: This study analyzed aspiration risk factors, microbiology patterns, and empiric anti-anaerobic use in patients hospitalized with CAP. Results showed that patients with ACAP or CAP/AspRF+ had similar anaerobic flora compared with those without aspiration risk factors, and Gram-negative bacteria were more prevalent in severe ACAP patients. Despite similar microbiological flora between groups, a large proportion of CAP patients received anti-anaerobic antibiotic coverage.
Article
Critical Care Medicine
Mireia Ruiz-Castilla, Bruce Dos Santos, Claudia Vizcaino, Jacinto Baena, Patricia Guilabert, Judith Marin-Corral, Joan R. Masclans, Oriol Roca, Juan P. Barret
Summary: This study aimed to analyze the association between inflammatory markers and biomarkers of epithelial injury with pneumonia incidence in patients with inhalation injury. The results demonstrated that plasma sST2 in the first 24 hours of admission can predict the occurrence of pneumonia in these patients.
Editorial Material
Critical Care Medicine
Judith Marin-Corral, Angela Garcia-Sanz, Joan Ramon Masclans
Article
Infectious Diseases
Santiago Grau, Daniel Echeverria-Esnal, Silvia Gomez-Zorrilla, Maria Eugenia Navarrete-Rouco, Joan Ramon Masclans, Merce Espona, Maria Pilar Gracia-Arnillas, Xavier Duran, Merce Comas, Juan Pablo Horcajada, Olivia Ferrandez
Summary: The study found an increase in antimicrobial consumption during the first wave of COVID-19 pandemic, especially in the ICU. Different antibiotics showed a clear temporal pattern in their usage. Availability of updated protocols and antimicrobial stewardship programs are essential to optimize these outcomes.
Editorial Material
Critical Care Medicine
Oriol Roca, Lluis Blanch, Gonzalo Hernandez
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2022)
Article
Psychiatry
Valentina Decio, Philippe Pirard, Baptiste Pignon, Olivier Bouaziz, Vittorio Perduca, Francis Chin, Yann Le Strat, Jonathan Messika, Viviane Kovess-Masfety, Emmanuelle Corruble, Nolwenn Regnault, Sarah Tebeka
Summary: Compared to hospitalizations for other reasons, patients hospitalized for COVID-19 during the first wave of the pandemic in France had a higher risk of subsequent hospitalization for psychiatric disorders during the 12 months following initial discharge.
EUROPEAN PSYCHIATRY
(2022)
Article
Immunology
Yousra Kherabi, Jonathan Messika, Nathan Peiffer-Smadja
Summary: This review provides an overview of the literature on machine learning (ML) for clinical decision support in antimicrobial stewardship in solid organ transplantation (SOT). ML may improve the prediction of infectious complications and the diagnosis and treatment of infectious diseases in SOT recipients. However, more research is needed in this specific population to design ML-driven clinical decision support systems and report clinical outcomes.
TRANSPLANT INFECTIOUS DISEASE
(2022)
Article
Infectious Diseases
Alexy Tran-Dinh, Marion Guiot, Sebastien Tanaka, Brice Lortat-Jacob, Enora Atchade, Nathalie Zappella, Pierre Mordant, Yves Castier, Herve Mal, Gaelle Weisenburger, Jonathan Messika, Nathalie Grall, Philippe Montravers
Summary: This study describes the prevalence, risk factors, morbidity, and mortality associated with bacteraemia during the postoperative ICU stay after lung transplantation. Bacteraemia is common and associated with significant morbidity and mortality in lung transplant recipients.
Article
Surgery
Antoine Roux, Vincent Bunel, Natalia Belousova, Jonathan Messika, Sebastien Tanaka, Mathilde Salpin, Arnaud Roussel, Laurence Beaumont-Azuar, Clement Picard, Olivier Brugiere, Jerome Devaquet, Edouard Sage, Morgan Le Guen, Jean-Luc Taupin, Magali Devriese, Mathieu Glorion, Francois Parquin
Summary: Lung transplant candidates who are highly sensitized against human leucocyte antigen present a challenge in finding suitable donors. Current desensitization strategies have limitations. Imlifidase, a novel agent derived from Streptococcus pyogenes, has been used successfully to remove antibodies and allow transplantation in kidney candidates. We present the first case of using imlifidase for antibody depletion in a highly sensitized lung transplant candidate who underwent a successful bilateral lung transplant.
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
Editorial Material
Critical Care Medicine
Oriol Roca, Ewan C. Goligher, Marcelo B. P. Amato
INTENSIVE CARE MEDICINE
(2023)
Editorial Material
Respiratory System
Jonathan Messika, Bernard Maitre, Nicolas Roche, Stephane Jouneau
RESPIRATORY MEDICINE AND RESEARCH
(2023)
Letter
Respiratory System
Etienne-Marie Jutant, Maeva Zysman, Thomas Gille, Jonathan Messika, Bernard Maitre, Maxime Patout, Lucile Sese
Letter
Critical Care Medicine
Oriol Roca, Ewan C. Goligher, Marcelo B. P. Amato
INTENSIVE CARE MEDICINE
(2023)
Editorial Material
Respiratory System
Domitille Mouren, Antoine Khalil, Jonathan Messika
RESPIRATORY MEDICINE AND RESEARCH
(2022)
Article
Critical Care Medicine
Oriol Roca, Oriol Caritg, Manel Santafe, Francisco J. Ramos, Andres Pacheco, Marina Garcia-de-Acilu, Ricard Ferrer, Marcus J. Schultz, Jean-Damien Ricard
Summary: The study found that closed-loop oxygen control improves oxygen administration in patients with moderate to severe acute hypoxemic respiratory failure (AHRF) treated with high flow nasal oxygen (HFNO), increasing the percentage of time spent in the optimal oxygenation range and decreasing the workload of healthcare personnel.