Due to the worldwide demand for ventilators increasing, we are receiving regular requests about ventilator supply. Fisher & Paykel Healthcare does not manufacture mechanical ventilators. We produce other respiratory support and humidification products, and associated consumables. For the latest updates on using our products to treat patients with COVID‑19, visit our COVID-19 Resource Center.

Optiflow™
Nasal High Flow 
therapy

Reducing patient escalation
across the care continuum.


 

 

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Using Optiflow to reduce the
escalation of care for patients


High flow nasal cannula (HFNC), high flow therapy (HFT), high flow oxygen/therapy (HFO/T), nasal high flow (NHF), high flow nasal prongs (HFNP), high flow oxygen (HFO), humidified, high flow nasal cannula (HHFNC), heated, humidified high flow nasal cannula (HHHFNC), humidified high flow therapy (HHFT), nasal insufflation or just plain high flow (HF) are the all the same therapy.

While many acronyms have been used for this therapy, one name stands out as the way to deliver it: Optiflow.
Optiflow NHF therapy from Fisher & Paykel Healthcare is at the forefront of the field, featuring in
hundreds of publications and appearing in such prestigious journals as the NEJM and JAMA.
Using Optiflow NHF therapy as a first-line treatment (both pre-intubation and post-extubation) may reduce
a patient’s escalation “up the acuity curve”, resulting in better patient outcomes.

 



“Use of NHF reduced the risk of reintubation within 72 hours.”

(among extubated patients at low risk of reintubation).

~ Hernández. et al. JAMA. Apr 2016.



“NHF significantly
reduced the need for intubation in more acute patients.”

(compared to standard O2 and NIV, PaO2:FiO2 ≤ 200 mmHg).

~ Frat et al. New Engl J Med. 2015.



“NHF was non-inferior to BPAP for treatment failure.”

(among extubated patients post cardiothoracic surgery).

~ Stéphan et al. JAMA. 2015.

Optiflow™ Nasal High Flow at the Royal Berkshire Hospital

Royal Berkshire Hospital (a multi-department implementation)


Optiflow™ NHF therapy at the Royal Berkshire Hospital. This video shows the usage of the F&P AIRVO™ 2 Humidified High Flow System & Optiflow NHF therapy in different departments of the Royal Berkshire Hospital in Reading, UK. It shows the benefits they have found both to the patients and hospital since its introduction.

(3 minutes long)

Post-Extubation video

Extubating to
Optiflow NHF therapy


This video depicts extubation to Optiflow NHF therapy, and is based on the procedure used by Dr. Hernández and his colleagues' in the following studies:
1. Hernández et al. JAMA. 2016 (April) and
2. Hernández et al. JAMA. 2016 (Oct.) 

How does Optiflow work?


The mechanisms of action

With Optiflow NHF therapy, you can independently titrate flow and FiO2 to match your patient’s needs. The mechanisms of action differ from those of conventional therapies, as do the resulting physiological effects and clinical outcomes.

The Optiflow NHF therapy mechanisms of action are: 

  • Respiratory support (through the reduction of dead space
    and delivery of a dynamic positive airway pressure)
  • Airway hydration
  • Patient comfort
  • Supplemental oxygen (if required)

These mechanisms contribute to physiological effects such as reduced respiratory rate, improved oxygenation, reduced carbon dioxide levels, and improved mucus clearance.

Note: the above mechanisms of action for nasal high flow apply to delivery through an Optiflow nasal cannula interface. The mechanisms of action differ when high flow is delivered through a tracheostomy or mask interface adapter.

Optiflow Mechanisms
Optiflow High Flow airway hydration mechanism overview
Airway hydration
 
Optiflow High Flow deadspace mechanism overview
Respiratory support
 
Optiflow High Flow pressure mechanism overview
Dynamic Positive Airway Pressure
 

Optiflow newsletter - Flow Matters


Keep up to date with the latest in Optiflow High Flow therapy clinical research.

Flow Matters ISSUE 9


Read about the validation and application of the ROX index

A tool that:
  • can be used to monitor patients and 
  • predict the likelihood of suceess or failure of Nasal High flow
  • requires just 3 data points
  • can be measured at the bedside
 
Read now Download PDF
Go With Flow - Issue 8

Issue 8 

(440 kb PDF)
 
First published clinical protocol detailing the application of High Flow therapy for adult patients with acute hypoxemic respiratory failure.
Go With The Flow Issue 7

Issue 7 

(315 kb PDF)
 
 Optiflow post extubation. Using Optiflow to reduce the risk of reintubation.
 
Go With The Flow Issue 7

Issue 6

(315kb PDF)
 
High flow therapy compared with conventional oxygen therapy and NIV.

Optiflow technology


Fisher & Paykel Healthcare technology was the first choice for the important studies published
in NEJM and JAMA, securing the place of Optiflow at the forefront of this exciting therapy.

Airvo™ 2 System

At a flow of 2 to 60 L/min, the AIRVO 2 is a standalone nasal high flow system can be used across the entire care continuum, from the ED and the ICU to the floors and in the home.
 

Optiflow™+ Nasal Cannula

The Optiflow + Nasal Cannula originated from Fisher & Paykel Healthcare's dedication to improve care and outcomes. 

MR850 System

The MR850 humidifier be used for the full range of Fisher & Paykel Healthcare therapies across the F&P Respiratory Care Continuum™.

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Resources


Optiflow Adult Clinical Paper Summaries

(PDF 0.8MB)

Download

Optiflow Therapy Brochure

(PDF 0.9MB)

Download

References


  1. Frat JP, Thille AW, Mercat A, Girault C, Ragot S, Perbet S et al. High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure. N Engl J Med. 2015;372(23):2185–96.
  2. Hernández G, Vaquero C, González P, Subira C, Frutos-Vivar F, Rialp G et al. Effect of Postextubation High-Flow Nasal Cannula vs Conventional Oxygen Therapy on Reintubation in Low-Risk Patients: A Randomized Clinical Trial. JAMA. (Apr) 2016; 315(13):1354–61.
  3. Stéphan F, Barrucand B, Petit P, Rézaiguia-Delclaux S, Médard A, Delannoy B et al. High-Flow Nasal Oxygen vs Noninvasive Positive Airway Pressure in Hypoxemic Patients After Cardiothoracic Surgery: A Randomized Clinical Trial. JAMA. 2015; 13(23):2331–9.

Reduced respiratory rate

  1. Sztrymf B, Messika J, Bertrand F, Hurel D, Leon R, Dreyfuss D et al. Beneficial effects of humidified high flow nasal oxygen in critical care patients: a prospective pilot study. Intensive Care Med. 2011; 37(11):1780–6.
  2. Corley A, Caruana LR, Barnett AG, Tronstad O, Fraser JF. Oxygen delivery through high-flow nasal cannulae increase end-expiratory lung volume and reduce respiratory rate in post-cardiac surgical patients. Br J Anaesth. 2011; 107(6):998–1004.
  3. Roca O, Riera J, Torres F, Masclans JR. High-Flow Oxygen Therapy in Acute Respiratory Failure. Respir Care. 2010; 55(4):408–13
  4. Lenglet H, Sztrymf B, Leroy C, Brun P, Dreyfuss D, Ricard JD. Humidified High Flow Nasal Oxygen During Respiratory Failure in the Emergency Department: Feasibility and Efficacy. Respir Care. 2012; 57(11):1873–8.
  5. Rittayamai N, Tscheikuna J, Rujiwit P. High-Flow Nasal Cannula Versus Conventional Oxygen Therapy After Endotracheal Extubation: A Randomized Crossover Physiologic Study. Respir Care. 2014; 59(4): 485–90.
  6. Roca O, Pérez-Terán P, Masclans JR, Pérez L, Galve E, Evangelista A et al. Patients with New York Heart Association class III heart failure may benefit with high flow nasal cannula supportive therapy: High flow nasal cannula in heart failure. J Crit Care. 2013; 28(5):741–6.
  7. Peters S, Holets S, Gay P. High-Flow Nasal Cannula Therapy in Do-Not-Intubated Patients with Hypoxemic Respiratory Distress. Respir Care. 2013; 58(4): 597-600.

Improved oxygenation

  1. Ritchie JE, Williams AB, Gerard C, Hockey H. Evaluation of a humidified nasal high flow oxygen system, using oxygraphy, capnography and measurement of upper airway pressures. Anaesth Intensive Care. 2011; 39(6):1103–10.
  2. Masclans JR, Roca O. High-Flow Oxygen Therapy in Acute Respiratory Failure. Clin Pulm Med. 2012; 19(3):127–30.
  3. Peters S, Holets S, Gay P. High-Flow Nasal Cannula Therapy in Do-Not-Intubated Patients with Hypoxemic Respiratory Distress. Respir Care. 2013; 58(4): 597–600.
  4. Sztrymf B, Messika J, Bertrand F, Hurel D, Leon R, Dreyfuss D et al. Beneficial effects of humidified high flow nasal oxygen in critical care patients: a prospective pilot study. Intensive Care Med. 2011; 37(11):1780–6.
  5. Corley A, Caruana LR, Barnett AG, Tronstad O, Fraser JF. Oxygen delivery through high-flow nasal cannulae increase end-expiratory lung volume and reduce respiratory rate in post-cardiac surgical patients. Br J Anaesth. 2011; 107(6):998–1004.
  6. Roca O, Riera J, Torres F, Masclans JR. High-Flow Oxygen Therapy in Acute Respiratory Failure. Respir Care. 2010; 55(4):408–13.
  7. Lucangelo U, Vassallo FG, Marras E, Ferluga M, Beziza E, Comuzzi L et al. High-Flow Nasal Interface Improves Oxygenation in Patients Undergoing Bronchoscopy. Crit Care Res Pract. 2012; (12):1–6.

Reduced carbon dioxide levels

  1. Möller W, Celik G, Feng S, Bartenstein P, Meyer G, Eickelberg O et al. Nasal high flow clears anatomical deadspace in upper airway models. J Appl Physiol. 2015; 118:1525–32.
  2. Mündel T, Feng S, Tatkov S, Schneider H. Mechanisms of nasal high flow on ventilation during wakefulness and sleep. J Appl Physiol. 2013; 114:1058–65.
  3. Jeong JH, Kim DH, Kim SC, Kang C, Lee SH, Kang TS et al. Changes in arterial blood gases after use of high-flow nasal cannula therapy in the ED. Am J Emerg Med. 2015;3(10):1344–9.

Improved mucus clearance

  1. Hasani A, Chapman TH, McCool D, Smith RE, Dilworth JP, Agnew JE. Domiciliary humidification improves lung mucociliary clearance in patients with bronchiectasis. Chron Respir Dis. 2008; 5(2):81–6.

Decreased escalation of care

  1. Frat JP, Thille AW, Mercat A, Girault C, Ragot S, Perbet S et al. High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure. N Engl J Med. 2015;372(23):2185–96.
  2. Hernández G, Vaquero C, González P, Subira C, Frutos-Vivar F, Rialp G et al. Effect of Postextubation High-Flow Nasal Cannula vs Conventional Oxygen Therapy on Reintubation in Low-Risk Patients: A Randomized Clinical Trial. JAMA. (Apr) 2016; 315(13):1354–61.
  3. Hernández G, Vaquero C, Colinas L, Cuena R, González P, Canabal A et al. Effect of Postextubation High-Flow Nasal Cannula vs Noninvasive Ventilation on Reintubation and Postextubation Respiratory Failure in High-Risk Patients. JAMA. (Oct) 2016; 316(15):1565–74.
  4. Stéphan F, Barrucand B, Petit P, Rézaiguia-Delclaux S, Médard A, Delannoy B et al. High-Flow Nasal Oxygen vs Noninvasive Positive Airway Pressure in Hypoxemic Patients After Cardiothoracic Surgery: A Randomized Clinical Trial. JAMA. 2015; 13(23):2331-9.

Reduced mortality rates

  1. Frat JP, Thille AW, Mercat A, Girault C, Ragot S, Perbet S et al. High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure. N Engl J Med. 2015;372(23):2185–96.

Improved symptomatic relief

  1. Frat JP, Thille AW, Mercat A, Girault C, Ragot S, Perbet S et al. High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure. N Engl J Med. 2015;372(23):2185–96.
  2. Roca O, Riera J, Torres F, Masclans JR. High-Flow Oxygen Therapy in Acute Respiratory Failure. Respir Care. 2010; 55(4):408-13.
  3. Lenglet H, Sztrymf B, Leroy C, Brun P, Dreyfuss D, Ricard JD. Humidified High Flow Nasal Oxygen During Respiratory Failure in the Emergency Department: Feasibility and Efficacy. Respir Care. 2012; 57(11):1873-8
  1. Frat JP, Thille AW, Mercat A, Girault C, Ragot S, Perbet S et al. High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure. N Engl J Med. 2015;372(23):2185–96.
  2. Hernández G, Vaquero C, González P, Subira C, Frutos-Vivar F, Rialp G et al. Effect of Postextubation High-Flow Nasal Cannula vs Conventional Oxygen Therapy on Reintubation in Low-Risk Patients: A Randomized Clinical Trial. JAMA. (Apr) 2016; 315(13):1354–61.
  3. Hernández G, Vaquero C, Colinas L, Cuena R, González P, Canabal A et al. Effect of Postextubation High–Flow Nasal Cannula vs Noninvasive Ventilation on Reintubation and Postextubation Respiratory Failure in High–Risk Patients. JAMA. (Oct) 2016; 316(15):1565–74.