Masclans J R, Pérez-Terán P, Roca O
Servicio de Medicina Intensiva, Hospital del Mar-Parc de Salut Mar, Institut Mar d'Investigacions Mèdiques (IMIM), Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España.
Servicio de Medicina Intensiva, Hospital del Mar-Parc de Salut Mar, Institut Mar d'Investigacions Mèdiques (IMIM), Barcelona, España.
Med Intensiva. 2015 Nov;39(8):505-15. doi: 10.1016/j.medin.2015.05.009. Epub 2015 Oct 1.
Acute respiratory failure represents one of the most common causes of intensive care unit admission and oxygen therapy remains the first-line therapy in the management of these patients. In recent years, high-flow oxygen via nasal cannula has been described as a useful alternative to conventional oxygen therapy in patients with acute respiratory failure. High-flow oxygen via nasal cannula rapidly alleviates symptoms of acute respiratory failure and improves oxygenation by several mechanisms, including dead space washout, reduction in oxygen dilution and inspiratory nasopharyngeal resistance, a moderate positive airway pressure effect that may generate alveolar recruitment and an overall greater tolerance and comfort with the interface and the heated and humidified inspired gases. However, the experience in adults is still limited and there are no clinical guidelines to establish recommendations for their use. This article aims to review the existing evidence on the use of high-flow oxygen via nasal cannula in adults with acute respiratory failure and its possible applications, advantages and limitations.
急性呼吸衰竭是重症监护病房收治的最常见病因之一，氧疗仍然是这些患者管理中的一线治疗方法。近年来，经鼻高流量给氧已被描述为急性呼吸衰竭患者传统氧疗的一种有效替代方法。经鼻高流量给氧通过多种机制迅速缓解急性呼吸衰竭症状并改善氧合，包括无效腔冲洗、减少氧稀释和吸气时鼻咽部阻力、可能产生肺泡复张的适度气道正压效应以及对接口和加热加湿吸入气体的总体更高耐受性和舒适度。然而，成人方面的经验仍然有限，并且没有临床指南来制定关于其使用的建议。本文旨在综述经鼻高流量给氧在成人急性呼吸衰竭中的现有使用证据及其可能的应用、优点和局限性。
