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Who is nasal high flow (NHF) for, i.e. who might benefit from NHF therapy?

The short answer is patients breathing on their own (who don’t require immediate mechanical ventilation) with or at risk of respiratory distress, i.e. patients presenting with:
 

High
respiratory rate

Dyspnea

High work
of breathing

Low SpO2

High PaCO2

 

  • In an acute setting (Emergency Department or Intensive Care Unit), clinicians typically view NHF as a way of meeting or exceeding a patient’s inspiratory demand so the work of breathing is reduced in patients experiencing respiratory distress – delivering a controlled amount of oxygen to patients with comfort and convenience.
  • ​In a chronic setting (respiratory floor/ward, long-term care facility or home), clinicians may (for example) prescribe NHF primarily to help a patient with secretion clearance and secondarily to provide respiratory support.


Optiflow high flow therapy/Airvo 2 has been proven to be effective in patients:

  • with acute hypoxemic respiratory failure,
  • for post-extubation respiratory support,
  • for postoperative respiratory support,
  • for immunocompromised patients with acute hypoxemic respiratory failure and
  • for patients with COPD


The key to really understanding who can benefit from High Flow therapy is in understanding the mechanisms of action.


​Additionally protocols based on published research are starting to emerge for some patient populations. One of the first of these was published in 2017 by Ischaki et al. and is specific to patients with acute hypoxemic respiratory failure (AHRF).
Others have been published by


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