The document discusses high flow nasal cannula (HFNC) therapy, its components, benefits, and applications in respiratory care for adults and infants. It highlights the importance of humidified oxygen delivery for improved patient outcomes and comfort, as well as the evolution of equipment used for this therapy. Additionally, it contrasts HFNC with low flow nasal cannula therapy (LFNC) regarding cost and performance.

1. UNIVERSITY OF DAMMAM.
Collage Of Applied Medical Sciences.
Respiratory Care Department.
High flow nasal cannula (HFNC)
Tarfa Ahmed Al-Sabhan
Clinical instructor :Mr. Maher AlQuaimi

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What is high flow nasal cannula?!
Purposed and benefits.
Sitting and setup.
HFNC for adult.
HFNC for newborns and infants.
Indication and contraindication.
• Comparison between LFNC and HFNC.

3. • The high flow nasal cannula (HFNC) is a device used
to deliver fixed supplemental oxygen or airflow to a
patient or person in need of respiratory help
• high-flow nasal cannula (HFNC) oxygen therapy was
introduced, accompanied by heated humidification
systems to prevent the associated drying of upper
airway mucosa and to increase patient comfort.

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Delivery of optimally humidified and warm gases
Decreased work of breathing
Decreased body energy expenditure
Less problems with thickened secretions
Less problems with nasal irritation/septal damage
Patient comfort
Patient compliance
Optimized patient outcomes

5. • Vapotherm developed the 2000i High-Flow
Therapy system, which consisted of a
designated cannula with a heated
cartridge-type humidifier using membrane
technology for water vapor transfer.
• The Vapotherm 2000i was recalled in 2005
due to concerns of bacterial
contamination, but was reinstated after
manufacturing controls and
recommendations for use of only sterile
water, single-patient use, and disinfection
procedures.

6. • . The system uses a heated humidifier with
hot-plate and single-use water chamber,
similar to those for application for noninvasive
or invasive mechanical ventilation.
• A separate or combined air/O2 blender or airoxygen entrainment device and flow meter
provide oxygen.
• An oxygen analyzer is also required.
• Humidified gas mixtures exit the humidifier
through large bore corrugated tubing that
connects to the cannula.

7. Air entrainment mask
Oxygen hood
Incubators
Oxygen tent

8. • . (1) High-flow nasal
cannula.
• (2) Pneumotachograph.
(3) Oxymeter.
• (4) Heater/humidifier.
• (5) Continuous high-flow
generator with the
Venturi effect.

9. • A delivery system to provide HFNC oxygen requires 3
components: a patient interface, a gas delivery device(s) to
control flow and FIO2, and a humidifier.
• Several manufacturers provide cannulas of similar style and
appearance, which are designated for high-flow applications.
• The Fisher & Paykel OptiFlow cannulas use a different design.
The nasal prongs are held in place on the upper lip with an
elastic over-ear head band
• They are available in large, medium, and small sizes

10. 10 to 60 L/min

11. • The HFNC offers potential for improved oxygen delivery for a
majority of patients with moderate hypoxemic respiratory
failure.
• The HFNC can be adapted for use in a variety of clinical
settings (exercise lab, ED, and ICU).
• The physical exam findings of reduction in breathing
frequency can provide a reliable guide to predict improved
oxygenation, as well as treatment failures, in addition to SpO2
monitoring.

12. Continuous positive airway pressure

13. • As was mentioned previously, the clinical application of nasal
cannula oxygen with flow > 1 L/min applied to premature babies,
newborns, and pediatric patients had an earlier and slightly different
evolution than with adults.
• A number of patient interfaces were initially developed for NCPAP,
including head-hood or facial chamber, sealing face or nasal mask,
and long nasopharyngeal tube.
• Currently NCPAP is most commonly applied using short bi-nasal
pharyngeal prongs, with humidified gas source and circuit.

14. at 1-8L/min

15. NRM Vs. HFNC

16. Heated humidifier Fisher & Paykel

17. • Respiratory distress from bronchiolitis, pneumonia, congestive
heart failure, etc
• Respiratory support post extubation and mechanical ventilation
• Weaning therapy from mask CPAP or BIPAP
• Respiratory support to children with neuromuscular disease
• Apnoea of prematurity

18. • Blocked nasal passages.
• Trauma/surgery to nasopharanyx

19. HFNC
• More expensive(stand, blender/flow meter/analyzer,
humidifier, heated-wire circuit, and cannula)
• Fixed performance
• Use with heated humidifier.
LFNC
• Less expensive.
• Variable performance.
• Use with unheated bubble humidifier.