Optiflow™
Flow Matters

Published evidence continues to published almost weekly demonstrating the contribution of Nasal High Flow to improved patient care and outcomes.
Flow Matters is designed to keep health professionals up to date with emerging clinical evidence and practice.

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Nasal High Flow publications by year

Search query: nasal high flow
(as of 25th Jan 2021)

Registered clinical trials

506 trials registered against the search term nasal high flow
(as of 25th Jan 2021)

Flow matters COVID-19 edition - updated July 21

*Data collated from Wilson et al. 2021.1
† FEV: Forced expiratory volume manoeuvres. Used as proxies for symptomatic laboured breathing and atelectasis.
This important update captures some of the latest evidence related to: 1. clinical outcomes associated with the use of nasal high flow (NHF) in COVID-19 treatment and 2. the transmission of particles from respiratory activities such as talking, exercise and cough when compared with NHF.

"[NHF] use is associated with a reduction in the rate of invasive mechanical ventilation and overall mortality in patients with COVID-19 infection."


-Patel et al. 2020.10

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Clinical practice guideline

 
(Rochwerg et al. 2020. Intensive Care Med.)
This clinical practice guideline (Rochwerg et al. 2020. Intensive Care Med.) synthesizes current best evidence into four recommendations for NHF in adult patients.

Acute hypoxemic
respiratory failure

For primary respiratory support compared to COT.
Recommendation made with moderate certainty.


 

 Strong
Recommendation 

Post-operative
 
For primary respiratory support compared to COT in high risk and/or obese patients following cardiac or thoracic surgery.
Recommendation made with moderate certainty.


 Conditional Recommendation 
Peri-intubation
 
For pre-oxygenation prior to in-ICU intubation no recommendation is made compared to COT.
NHF during intubation should be continued for patients who are already receiving NHF.*

 Continue NHF* 
Post-extubation
respiratory failure
 
For post-extubation respiratory support compared to COT following extubation.
Recommendation made with moderate certainty.



 Conditional Recommendation 

*For patients who are already receiving NHF, guideline authors suggest continuing NHF during intubation (conditional recommendation, moderate certainty).

Flow Matters

In this edition of Flow Matters we outline the recommendations, discuss the evidence-practice gap, the economics of Nasal High Flow and survey the studies used to establish these guidelines to determine which High Flow technology was used.

 

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 		 What systems and settings are
used in NHF research?
Surveys of the studies comprising
the body of NHF evidence found
the majority used F&P Optiflow
systems and flow settings between
45 and 60L/min.		 PDF Read online

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 		 NHF is recognized by the
WHO for treatment of patients with
COVID-19.
Read about this and research
related to airborne transmission.		 PDF Read online

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 		 A bedside tool for
monitoring patients on NHF.
The validated ROX index uses just 3
data points to provide an indicator
of outcomes in adults with AHRF
receiving NHF therapy.


AUTHOR:
Stanislav Taktov, M.D., Ph.D.		 PDF Read online

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A resource center has been created to provide affected hospitals and healthcare professionals with information they may need to treat patients when using Fisher & Paykel Healthcare products.
 

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