Optiflow™
Nasal High Flow 
therapy

Reducing patient escalation
across the care continuum.

 

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Videos of Optiflow in use

Therapy FAQs

Optiflow/Airvo products

Resources and downloads

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)

While many terms are used for this therapy, one name stands out as the way to deliver it.
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.

The science behind Optiflow therapy

From physiological effects derived from the mechanisms of action to the all-important clinical outcomes how exactly do patients benefit from Optiflow Nasal High Flow therapy?

Mechanisms of action

How Nasal High Flow Works
e.g. Increased alveolar ventilation
 

Physiological effects 

What Nasal High Flow does

e.g. Reduced dyspnea

Clinical
Outcomes

What it means for patients
e.g. Reduced intubation rate
 


App new icon

Download the F&P ROX index calculator app

Using just 3 data points (SpO2, respiratory rate and FiO2) the validated ROX index* provides an indicator of Nasal High Flow outcomes in adults experiencing acute hypoxemic respiratory failure due to pneumonia. Download the app to learn more about and practice using this index.
 
App Store Download Play Store Download
*Roca et al. Am J Respir Crit Care Med. 2019.
 
     
ROX app
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.) 

Optiflow Nasal High Flow therapy -
frequently asked questions

FAQ speech box 1

Who does
Nasal High Flow
work on?

FAQ speech box 2

How quickly
does Nasal High
Flow work?

FAQ speech box 3

Is there a
protocol for
use of Nasal
High Flow?

FAQ speech box 4

Is there a bedside tool to predict the outcome of Nasal High Flow?

 
Take me to FAQs

 

Optiflow newsletter - Flow Matters

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

Flow Matters

Edition 11 (August 2020)

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 60 L/min.
 
Read now Download PDF
Flow Matters- Issue 10

Issue 10 

NHF is recognized by the WHO for treatment of patients with COVID-19. 
Read about this and research related to airborne transmission.
Go With The Flow Issue 7

Issue 9 

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.
Go With The Flow Issue 7

Issue 8

Featured study,
Ischaki et al. 2018.
First published clinical protocol detailing the application of High Flow therapy for adult patients with acute hypoxemic respiratory failure.

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.

F&P AIRVO 2

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. 
F&P MR850 Humidifier

MR850 System

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

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

Optiflow Therapy Resources

Optiflow Cannula Fitting

F&P ROX index app

 
(Mobile App)
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Optiflow Cannula Fitting

Frat et al FLORALI study infographic

(PDF)
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Optiflow Cannula Fitting

Optiflow therapy brochure

 
(PDF 0.9MB)
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Optiflow Cannula Fitting

Flow Matters 11

Optiflow Cannula Fitting

Flow Matters 10

Optiflow Cannula Fitting

Flow Matters 9

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