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How should I monitor patients on NHF?


Evidence shows that when NHF is applied early enough (in patients who respond to therapy) you should see improvement in oxygenation, RR, dyspnea within 15-30 mins. Monitoring should continue beyond this of course.

The recent addition of the ROX index, calculated from 3 data points collected at the bedside, can provide an indicator of NHF outcome in the first few hours of treatment, and beyond.

Protocols based on published research are starting to emerge for some patient populations. One of the first of these was published in 2017 by Ischaki et al. and is specific to patients with acute hypoxemic respiratory failure (AHRF). Others have been published by Ricard et al 2019, d’Espiney et al 2020 (hypercapnia), Pantazopoulos et al 2020 (COPD with Hypercapnic respiratory failure) and Raoof et al 2020 (COVID-19).

Dr Jean-Pierre Frat Patient Escalation

 


Watch Dr. Frat (first-named author of the landmark FLORALI study) discuss his approach to monitoring patients initiated on NHF therapy.


How do you monitor patients and make the decision to escalate?
(6 min 09 sec)