Optiflow™
Flow Matters

Evidence continues to published almost weekly demonstrating the contribution of Nasal High Flow (NHF) to improved patient care and outcomes.

Optiflow Flow Matters is designed to keep you up to date with this emerging clinical evidence and practice guidelines.


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Over recent years, there has been an exponential increase in published clinical evidence and interest in NHF.
Publications by year
(as of 21st Oct. 2021)

pubmed.com - search term 'nasal high flow'
Registered clinical trials
(as of 21st Oct. 2021)

clinicaltrials.gov - search term 'nasal high flow'

NHF therapy in pediatric care

The use of NHF as a primary treatment for infants with bronchiolitis in the ED resulted in a significantly lower rate of therapy failure compared with standard oxygen therapy.
1 in 9 patients experienced therapy failure on
NHF 2 L/kg/min
1 in 4 patients experienced therapy failure on
standard O2 < 2 L/min



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.

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Clinical practice guideline recommendations

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

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Acute hypoxemic
respiratory failure


Acute hypoxemic
respiratory failure

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

Strong
Recommendation 

Post-operative

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

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* 

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

Post-extubation
respiratory failure

 
For post-extubation respiratory support compared to COT following extubation.
Recommendation made with moderate certainty.

Conditional Recommendation 



Clinical practice guidelines

In this edition of Flow Matters, we outline the recommendations, discuss the evidence-practice gap, and the economics of Nasal High Flow.

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Updated 9thNov21
 

Evidence-based guidelines recommend the use of NHF for COVID-19 patients


Read about this and research related to airborne transmission.


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Updated 9thNov21
 

Evidence-based guidelines recommend the use of NHF for COVID-19 patients 

Read about this and research related to airborne transmission.

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ROX Index - 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.

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A survey - the NHF systems & settings used in published research

Surveys of the studies comprising the body of NHF evidence found the majority used F&P Optiflow NHF therapy systems and flow settings between 45 and 60 L/min.

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