Nasal High Flow Reduces Dead Space

Overview

Journal J Appl Physiol (1985)

Publisher American Physiological Society

Date 2016 Nov 19

PMID 27856714

Citations 95

Authors

Winfried Moller

Sheng Feng

Ulrike Domanski

Karl-Josef Franke

Gulnaz Celik

Peter Bartenstein

Sven Becker

Gabriele Meyer

Otmar Schmid

Oliver Eickelberg

Stanislav Tatkov

Georg Nilius

Affiliations

Soon will be listed here.

Abstract

New & Noteworthy: Clearance of expired air in upper airways by nasal high flow (NHF) can be extended below the soft palate and de facto causes a reduction of dead space. Using scintigraphy, the authors found a relationship between NHF, time, and clearance. Direct measurement of CO and O in the trachea confirmed a reduction of rebreathing, providing the actual data on inspired gases, and this can be used for the assessment of other forms of respiratory support.

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References

Vargas F, Saint-Leger M, Boyer A, Bui N, Hilbert G . Physiologic Effects of High-Flow Nasal Cannula Oxygen in Critical Care Subjects. Respir Care. 2015; 60(10):1369-76. DOI: 10.4187/respcare.03814. View

Hart M, Orzalesi M, Cook C . Relation between anatomic respiratory dead space and body size and lung volume. J Appl Physiol (1985). 2019; 18(3):519-522. DOI: 10.1152/jappl.1963.18.3.519. View

Lewis S, Martin C . Characteristics of the washout dead space. Respir Physiol. 1979; 36(1):51-63. DOI: 10.1016/0034-5687(79)90014-8. View

Nilius G, Wessendorf T, Maurer J, Stoohs R, Patil S, Schubert N . Predictors for treating obstructive sleep apnea with an open nasal cannula system (transnasal insufflation). Chest. 2009; 137(3):521-8. DOI: 10.1378/chest.09-0357. View

Cretikos M, Bellomo R, Hillman K, Chen J, Finfer S, Flabouris A . Respiratory rate: the neglected vital sign. Med J Aust. 2008; 188(11):657-9. DOI: 10.5694/j.1326-5377.2008.tb01825.x. View

Budweiser S, Baur T, Jorres R, Kollert F, Pfeifer M, Heinemann F . Predictors of successful decannulation using a tracheostomy retainer in patients with prolonged weaning and persisting respiratory failure. Respiration. 2012; 84(6):469-76. DOI: 10.1159/000335740. View

Lee J, Rehder K, Williford L, Cheifetz I, Turner D . Use of high flow nasal cannula in critically ill infants, children, and adults: a critical review of the literature. Intensive Care Med. 2012; 39(2):247-57. DOI: 10.1007/s00134-012-2743-5. View

Spoletini G, Alotaibi M, Blasi F, Hill N . Heated Humidified High-Flow Nasal Oxygen in Adults: Mechanisms of Action and Clinical Implications. Chest. 2015; 148(1):253-261. DOI: 10.1378/chest.14-2871. View

Sotello D, Rivas M, Mulkey Z, Nugent K . High-flow nasal cannula oxygen in adult patients: a narrative review. Am J Med Sci. 2014; 349(2):179-85. DOI: 10.1097/MAJ.0000000000000345. View

10.

Mundel T, Feng S, Tatkov S, Schneider H . Mechanisms of nasal high flow on ventilation during wakefulness and sleep. J Appl Physiol (1985). 2013; 114(8):1058-65. PMC: 3633436. DOI: 10.1152/japplphysiol.01308.2012. View

11.

Nilius G, Franke K, Domanski U, Ruhle K, Kirkness J, Schneider H . Effects of nasal insufflation on arterial gas exchange and breathing pattern in patients with chronic obstructive pulmonary disease and hypercapnic respiratory failure. Adv Exp Med Biol. 2012; 755:27-34. DOI: 10.1007/978-94-007-4546-9_4. View

12.

Frizzola M, Miller T, Rodriguez M, Zhu Y, Rojas J, Hesek A . High-flow nasal cannula: impact on oxygenation and ventilation in an acute lung injury model. Pediatr Pulmonol. 2010; 46(1):67-74. PMC: 3332105. DOI: 10.1002/ppul.21326. View

13.

Moller W, Celik G, Feng S, Bartenstein P, Meyer G, Oliver E . Nasal high flow clears anatomical dead space in upper airway models. J Appl Physiol (1985). 2015; 118(12):1525-32. PMC: 4482836. DOI: 10.1152/japplphysiol.00934.2014. View

14.

Kallet R, Zhuo H, Liu K, Calfee C, Matthay M . The association between physiologic dead-space fraction and mortality in subjects with ARDS enrolled in a prospective multi-center clinical trial. Respir Care. 2014; 59(11):1611-8. PMC: 4077995. DOI: 10.4187/respcare.02593. View

15.

McGinley B, Patil S, Kirkness J, Smith P, Schwartz A, Schneider H . A nasal cannula can be used to treat obstructive sleep apnea. Am J Respir Crit Care Med. 2007; 176(2):194-200. PMC: 1994212. DOI: 10.1164/rccm.200609-1336OC. View

16.

Dysart K, Miller T, Wolfson M, Shaffer T . Research in high flow therapy: mechanisms of action. Respir Med. 2009; 103(10):1400-5. DOI: 10.1016/j.rmed.2009.04.007. View

17.

Sztrymf B, Messika J, Mayot T, Lenglet H, Dreyfuss D, Ricard J . Impact of high-flow nasal cannula oxygen therapy on intensive care unit patients with acute respiratory failure: a prospective observational study. J Crit Care. 2011; 27(3):324.e9-13. DOI: 10.1016/j.jcrc.2011.07.075. View

18.

Stephan F, Barrucand B, Petit P, Rezaiguia-Delclaux S, Medard A, Delannoy B . High-Flow Nasal Oxygen vs Noninvasive Positive Airway Pressure in Hypoxemic Patients After Cardiothoracic Surgery: A Randomized Clinical Trial. JAMA. 2015; 313(23):2331-9. DOI: 10.1001/jama.2015.5213. View

19.

Leino K, Nunes S, Valta P, Takala J . Validation of a new respiratory inductive plethysmograph. Acta Anaesthesiol Scand. 2001; 45(1):104-11. DOI: 10.1034/j.1399-6576.2001.450116.x. View

20.

Fraser J, Spooner A, Dunster K, Anstey C, Corley A . Nasal high flow oxygen therapy in patients with COPD reduces respiratory rate and tissue carbon dioxide while increasing tidal and end-expiratory lung volumes: a randomised crossover trial. Thorax. 2016; 71(8):759-61. PMC: 4975837. DOI: 10.1136/thoraxjnl-2015-207962. View