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DOI: 10.1055/s-0042-1745746
Effect of Two Different Temperature Settings on Patient Comfort Level during Respiratory Therapy by High-Flow Nasal Cannula
Funding This study was funded by the ESIC Medical College, NH-3, Faridabad.
Abstract
Background Hypoxemic respiratory failure may require high flow O2 therapy (>15 L/m), which can be delivered using a high-flow nasal cannula (HFNC) device. There are three variables: FiO2, flow, and temperature that can be controlled while using HFNC. This study was planned to assess the degree of comfort level of patients at two different temperature settings.
Methods A prospective interventional cross-over study was performed on 40 hypoxemic respiratory failure patients, who were on HFNC. Primary outcome was to assess patient comfort during HFNC therapy at two different temperatures (31 and 37°C), at the flow of 60 L/m for 30 minutes at each temperature setting, leaving FiO2 unchanged. After 30 minutes of each temperature setting, the comfort level was assessed using 11 score visual numerical scale (ranging from 0 to 10) together with other vital parameters.
Result Patients were found to be more comfortable at temperature settings of 31°C than at 37°C (p-value < 0.05%). Also, an increase in blood pressure was observed at 37°C after completion of 30 minutes, which was statistically significant but not clinically significant.
Conclusion Starting HFNC therapy at lower temperature gives better patient acceptance and reduces chances of failure due to discomfort.
Authors' Contributions
Dr. Mamta Kumari– concept, design, literature search.
Dr. Megha Soni- data acquisition, literature search.
Dr. Niharika Grover-literature search, definition of intellectual content, manuscript preparation.
Dr. Rashmi Taneja –manuscript editing and review.
Dr. Mamta Kumari is the guarantor and takes the responsibility for the integrity of work as a whole from inception to published article.
Declaration
This manuscript has been read and approved by all the authors, requirements for authorship have been met, and each author believes that the manuscript presents the honest work. Article is not published nor under consideration, in part or whole simultaneously in any other journal or any other proceedings.
Publication History
Article published online:
14 April 2022
© 2022. Medical and Surgical Update Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Hernández G, Roca O, Colinas L. High-flow nasal cannula support therapy: new insights and improving performance. Crit Care 2017; 21 (01) 62
- 2 Roca O, Riera J, Torres F, Masclans JR. High-flow oxygen therapy in acute respiratory failure. Respir Care 2010; 55 (04) 408-413
- 3 Sztrymf B, Messika J, Mayot T, Lenglet H, Dreyfuss D, Ricard JD. Impact of high-flow nasal cannula oxygen therapy on intensive care unit patients with acute respiratory failure: a prospective observational study. J Crit Care 2012; 27 (03) 324.e9-324.e13
- 4 Sztrymf B, Messika J, Bertrand F. et al. Beneficial effects of humidified high flow nasal oxygen in critical care patients: a prospective pilot study. Intensive Care Med 2011; 37 (11) 1780-1786
- 5 Hernández G, Vaquero C, González P. et al. Effect of postextubation highflownasal cannula vs conventional oxygen therapy on reintubation in lowrisk patients. A randomized clinical trial. JAMA 2016; 315 (13) 1354-1361
- 6 Frat JP, Thille AW, Mercat A. et al; FLORALI Study Group, REVA Network. High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. N Engl J Med 2015; 372 (23) 2185-2196
- 7 Delorme M, Bouchard PA, Simon M, Simard S, Lellouche F. Effects of high-flow nasal cannula on the work of breathing in patients recovering from acute respiratory failure. Crit Care Med 2017; 45 (12) 1981-1988
- 8 Azoulay E, Pickkers P, Soares M. et al; Efraim investigators and the Nine-I study group. Acute hypoxemic respiratory failure in immunocompromised patients: the Efraim multinational prospective cohort study. Intensive Care Med 2017; 43 (12) 1808-1819
- 9 Frat JP, Brugiere B, Ragot S. et al. Sequential application of oxygen therapy via high-flow nasal cannula and noninvasive ventilation in acute respiratory failure: an observational pilot study. Respir Care 2015; 60 (02) 170-178
- 10 Schwabbauer N, Berg B, Blumenstock G, Haap M, Hetzel J, Riessen R. Nasal high-flow oxygen therapy in patients with hypoxic respiratory failure: effect on functional and subjective respiratory parameters compared to conventional oxygen therapy and non-invasive ventilation (NIV). BMC Anesthesiol 2014; 14: 66-73
- 11 Patel BK, Wolfe KS, Pohlman AS, Hall JB, Kress JP. Effect of noninvasive ventilation delivered by helmet vs face mask on the rate of endotracheal intubation in patients with acute respiratory distress syndrome: a randomized clinical trial. JAMA 2016; 315 (22) 2435-2441
- 12 Liu Q, Gao Y, Chen R, Cheng Z. Noninvasive ventilation with helmet versus control strategy in patients with acute respiratory failure: a systematic review and meta-analysis of controlled studies. Crit Care 2016; 20: 265-279
- 13 Hernández G, Vaquero C, Colinas L. et al. Effect of postextubation high-flow nasal cannula vs noninvasive ventilation on reintubation and postextubation respiratory failure in high-risk patients: a randomized clinical trial. JAMA 2016; 316 (15) 1565-1574
- 14 Frat JP, Ragot S, Coudroy R. et al; REVA network. Predictors of intubation in patients with acute hypoxemic respiratory failure treated with a noninvasive oxygenation strategy. Crit Care Med 2018; 46 (02) 208-215
- 15 Kolcaba K, Tilton C, Drouin C. Comfort Theory: a unifying framework to enhance the practice environment. J Nurs Adm 2006; 36 (11) 538-544
- 16 Krinsky R, Murillo I, Johnson J. A practical application of Katharine Kolcaba's comfort theory to cardiac patients. Appl Nurs Res 2014; 27 (02) 147-150
- 17 Mauri T, Galazzi A, Binda F. et al. Impact of flow and temperature on patient comfort during respiratory support by high-flow nasal cannula. Crit Care 2018; 22 (01) 120
- 18 Stéphan F, Bérard L, Rézaiguia-Delclaux S, Amaru P. BiPOP Study Group. BiPOP Study Group. High-flow nasal cannula therapy versus intermittent noninvasive ventilation in obese subjects after cardiothoracic surgery. Respir Care 2017; 62 (09) 1193-1202
- 19 Longhini F, Pan C, Xie J. et al. New setting of neurally adjusted ventilatory assist for noninvasive ventilation by facial mask: a physiologic study. Crit Care 2017; 21 (01) 170
- 20 Mauri T, Grasselli G, Pesenti A. Systematic assessment of advanced respiratory physiology: precision medicine entering real-life ICU?. Crit Care 2017; 21 (01) 143