Transnasal high flow humidification oxygen therapy

Transnasal high flow humidified oxygen therapy (HFNC) is a treatment method that continuously provides patients with adjustable and relatively constant oxygen concentration (21%~100%), temperature (31-37 ℃), and humidity through high flow nasal obstruction (8-80L/min). As a new type of respiratory support technology, it has been widely applied in clinical practice in recent years, with good comfort. It has played a positive role in saving patients' lives and promoting their early recovery.

The treatment equipment mainly includes air oxygen mixing devices, humidification devices, high flow nasal congestion, and connecting respiratory pipelines.

Air oxygen mixing section: Mix air and oxygen in front of the turbine according to a predetermined oxygen concentration.

Gas humidification part: It is the heating and humidification of the gas mixed with air and oxygen.

Gas delivery part: It ensures that the heated and humidified air oxygen mixture is delivered to the patient's body at a constant humidity and flow rate.

Indications and Contraindication:

Indications:

Mild and moderate type I Respiratory failure (100mmHg ≤ PaO2/FiO2<300mmHg).

Mild respiratory distress (respiratory rate>24bpm).

Mild ventilation dysfunction (pH ≥ 7.3).

The intolerance or Contraindication of conventional oxygen therapy or non-invasive positive pressure ventilation.

Relative Contraindication:

Severe type I Respiratory failure (PaO2/FiO2<100mmHg).

Ventilation dysfunction (pH<7.30).

Contradictory breathing.

Poor respiratory protection carries a high risk of aspiration.

Hemodynamic instability requires the use of vasoactive drugs.

HFNC cannot be worn during facial or upper respiratory surgery.

Severe nasal congestion.

HFNC paranoia.

Absolute Contraindication

Cardiac and respiratory arrest requires emergency Tracheal intubation and invasive mechanical ventilation.

Weak spontaneous breathing, coma.

Acute and severe type I Respiratory failure (PaO2/FiO2<60mmHg).

Ventilation dysfunction (pH<7.25).

Precautions for use:

Before using the machine, the treatment purpose should be explained and the patient's cooperation should be obtained. Recommend lying or high head position (>20 degrees).

2. Choose the correct type of nasal obstruction. It is recommended to choose a nasal catheter smaller than 50% of the inner diameter of the nostril.

3. Closely monitor vital signs, respiratory patterns, movement changes, and blood gas analysis, and make timely adjustments.

Instruct the patients with 4 Mouth breathing to cooperate with closed mouth breathing. If not, and there is no carbon dioxide retention, nasal congestion can be converted into nasal/mask oxygen therapy through an adapter.

For patients with poor tongue lowering and HFNC effects, first open the upper respiratory tract through the oropharyngeal airway, and then connect the nasal obstruction of HFNC to the oropharyngeal airway. If it cannot be improved, other non-invasive ventilation respiratory support methods can be considered.

6. Avoid excessive or insufficient humidification, closely observe changes in airway secretions, aspirate phlegm as needed, and prevent emergency events such as phlegm blockage and suffocation.

7. Pay attention to the phenomenon of pipeline water, handle it in a timely manner to prevent suffocation and accidental entry into the respiratory tract, maintain the patient's nasal congestion above the level of the machine and pipeline, and promptly handle condensation in the pipeline before giving an alarm.

If the patient cannot tolerate abnormal high temperatures, the examination should be stopped to avoid burning the airway.

9. It is recommended that the minimum flow rate should not be less than 15L/min.

10. Pay attention to adjusting the tightness of nasal obstruction and fixation to avoid facial skin damage caused by excessively tight straps.

If there are machine alarms and machine errors, promptly handle and record the error codes for the manufacturer to provide after-sales service and prevent the machine from continuing to be used.