Research in high flow therapy: Mechanisms of action - 07/08/11

Doi : 10.1016/j.rmed.2009.04.007

Kevin Dysart ^a,^b,^c,^⁎ , Thomas L. Miller ^a,^d, Marla R. Wolfson ^e,^f, Thomas H. Shaffer ^a,^b,^c,^e,^f
^a Department of Pediatrics, Jefferson Medical College/Thomas Jefferson University, Philadelphia, PA, USA
^b Department of Pediatrics, Nemours, Wilmington, DE, USA
^c Department of Biomedical Research, Nemours, Wilmington, DE, USA
^d Vapotherm, Inc., Stevensville, MD, USA
^e Department of Physiology, Temple University School of Medicine, Philadelphia, PA, USA
^f Department of Pediatrics, Temple University School of Medicine, Philadelphia, PA, USA

Correspondence to: Kevin Dysart, Suite 700 College Building, 1025 Walnut St., Philadelphia, PA 19107, USA. Tel.: +1 267 979 4397; fax: +1 215 923 9519.

Summary

Recently, heater/humidifier devices that use novel methods to condition breathing gases from an external source have been introduced. The addition of sufficient warmth and high levels of humidification to breathing gas has allowed for higher flow rates from nasal cannula devices to be applied to patients (i.e., high flow therapy). This article provides a review of the proposed mechanisms behind the efficacy of high flow therapy via nasal cannula, which include washout of nasopharyngeal dead space, attenuation of the inspiratory resistance associated with the nasopharynx, improvement in conductance and pulmonary compliance, mild distending pressure and reduction in energy expenditure for gas conditioning.

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Keywords : High flow nasal canula, Oxygen therapy, Humidification device, Nasal canula