nasal high flow therapy

Proven* respiratory support

*A review of studies comprising the body of NHF evidence found the majority used F&P Optiflow™ systems

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

Optiflow NHF therapy from Fisher & Paykel Healthcare is at the forefront of its field, featuring in hundreds of publications and prestigious journals such as 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.


Clinical Practice Guidelines for Nasal High Flow Therapy

“This clinical practice guideline synthesizes current best evidence into four recommendations for NHF in adult patients.”1

Nasal High Flow (NHF) therapy is recommended for use in several applications by published guidelines. A clinical practice guideline for NHF use as a respiratory strategy in adult patients requiring respiratory support was recently published in Intensive Care Medicine,1 the official journal of The European Society of Intensive Care Medicine (ESICM).

1. Rochwerg et al. 2020. Intensive Care Med.


Acute hypoxemic
respiratory failure

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



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 
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* 
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).

High flow in adults - Dr.Laurent Brochard

Watch Dr. Laurent Brochard present the ESICM clinical practice guidelines for use of NHF therapy as a respiratory support for adult patients. (28 mins)


Download this visual abstract for an overview of the clinical practice guideline.


Read our Flow Matters publication dedicated to the clinical practice guideline.


Latest Flow Matters Edition

Early use of NHF in infants and children

In our latest edition of Flow Matters, we review the literature and provide an evidence-based approach to implementation of NHF in pediatric patients.

Read online

Download PDF


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Optiflow Nasal High Flow in Practice

Optiflow™ Nasal High Flow at the Royal Berkshire Hospital (Optiflow Page)

A multi-department implementation of Optiflow NHF therapy

This video shows the introduction of the Airvo 2 device across departments of the Royal Berkshire Hospital in Reading, UK. Hospital clinicians talk about the benefits for the hospital and its patient since the Airvo 2 was introduced.
Extubating to Optiflow™ Nasal High Flow therapy

Extubation to Optiflow NHF therapy: Dr Hernández

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: Hernández et al. JAMA. 2016 (April)1 and Hernández et al. JAMA 2016 (Oct.)2

ROX Index Explained

The ROX index can be used to monitor patients and predict the likelihood of NHF therapy success or failure. 

It combines three common measurements: FiO2, SpO2, and respiratory rate, and it is based on two known facts about sicker patients. 1. They require more oxygen. 2. They have a higher respiratory rate.

The index has been validated in a multi-center prospective study conducted with 191 patients with pneumonia.*

Read Online  Download PDF


ROX* Index

Use the ROX Index
Calculator app

to learn about
entering the
and calculating the


ROX* Vector

Use the ROX
Vector app 
to learn
about visualizing trends
in the parameters
over time.

Search our FAQs



ROX Index* Calculator app

Free and available from the app Store and Google Play

ROX Vector* app

Free and available from the app Store and Google Play

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1800 446 3908 / +1949 453 4000

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