Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/13679
Title: Nasal high-flow oxygen therapy in ICU: A before-and-after study.
Authors: Fealy, Nigel G;Osborne, Clare;Eastwood, Glenn M;Glassford, Neil J;Hart, Graeme K;Bellomo, Rinaldo
Issue Date: 16-Jun-2015
Citation: Australian Critical Care 2016; 29(1): 17-22
Abstract: BACKGROUND: Non-intubated intensive care patients commonly receive supplemental oxygen by high-flow face mask (HFFM), simple face mask (FM) and nasal prongs (NP) during their ICU admission. However, high-flow nasal prongs (HFNP) offer considerable performance capabilities that may sufficiently meet all their oxygen therapy requirements. STUDY AIMS: To assess the feasibility, safety and cost-effectiveness of introducing a protocol in which HFNP was the primary oxygen delivery device for non-intubated intensive care patients. METHOD: Prospective 4-week before-and-after study (6 months apart) for all adult patients admitted to a 22-bed tertiary ICU in Melbourne, Australia. RESULTS: 117 patients (57 before, 60 after) were included: 86 (73.5%) received mechanical ventilation. Feasibility revealed a significant reduction in HFFM (52.6-0%, p<.001), FM (35.1-8.3%, p=.002) and NP (75.4-36.7%, p<.001) use and an increase in HFNP use (31.6-81.7%, p<.05) during the after period. Following extubation, there was a significant reduction in HFFM use (65.7% vs. 0%, p<.05) and an increase HFNP use (8.6% vs. 87.5%, p<.05). Costing was in favour of the after period with a consumable cost saving per patient (AUD $32.56 vs. $17.62, p<.05). During the after period, more patients were discharged from ICU with HFNP than during the before period (5 vs. 33 patients, p<.05) and fewer patients (5 vs. 14 patients) used three or more oxygen delivery devices. Safety outcomes demonstrated no significant difference in the number of intubations, re-intubations, readmissions or non-invasive ventilation use between the two time periods. CONCLUSIONS: Using HFNP as the primary oxygen delivery method for non-intubated intensive care patients was feasible, appeared safe, and the oxygen device costs were reduced. The findings of our single-centre study support further multi-centre evaluations of HFNP therapy protocols in non-ventilated intensive care patients.
URI: http://ahro.austin.org.au/austinjspui/handle/1/13679
DOI: 10.1016/j.aucc.2015.05.003
ORCID: 0000-0002-1650-8939
PubMed URL: http://www.ncbi.nlm.nih.gov/pubmed/26092213
Type: Journal Article
Subjects: Acute nursing care
Critical illness
Intensive care nasal high-flow
Nasal cannulae
Nasal prongs
Oxygen therapy
Appears in Collections:Journal articles

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