Girault C, Boyer D, Jolly G, Carpentier D, Béduneau G, Frat J-P
UNIROUEN, EA-3830, service de médecine intensive et réanimation, hôpitaux de Rouen, Normandie université, CHU, 76000 Rouen, France.
Service de médecine intensive et réanimation, hôpitaux de Rouen, CHU, 76000 Rouen, France.
Rev Mal Respir. 2022 May;39(5):455-468. doi: 10.1016/j.rmr.2022.03.012. Epub 2022 May 16.
First-line symptomatic treatment of acute respiratory failure (ARF) usually requires standard oxygen therapy, of which the limits have nonetheless led to the development of heated and humidified high-flow nasal oxygen therapy (HFNO). HFNO enables the delivery, through simple nasal cannula, of up to 100% of well-heated and humidified fraction of inspired oxygen (FiO), at a maximum flow rate of 50 to 70 L/min of gas according to the devices chosen (specific or ventilator). The technical characteristics and operating principles of HFNO (coverage of the patient's spontaneous inspiratory flow, improved conditioning of the inspired gases, comfortable nasal cannula) yield a number of interdependent physiological effects that improve not only oxygenation conditions but also ventilatory mechanics. While it could be indicated in many clinical situations, including first-line hypoxemic ARF, the simplicity of HFNO implementation and the respiratory comfort it procures should in no way minimize the clinical monitoring of patients for whom endotracheal intubation may be required, and should not be unduly delayed.
急性呼吸衰竭（ARF）的一线对症治疗通常需要标准氧疗，然而其局限性促使了温热湿化高流量鼻导管给氧疗法（HFNO）的发展。HFNO能够通过简单的鼻导管，根据所选设备（专用设备或呼吸机），以最高50至70升/分钟的气体流速，输送高达100%的温热湿化吸入氧分数（FiO）。HFNO的技术特性和工作原理（覆盖患者的自主吸气流量、改善吸入气体的调节、舒适的鼻导管）产生了许多相互依存的生理效应，不仅改善了氧合状况，还改善了通气力学。虽然HFNO可用于许多临床情况，包括一线低氧血症性ARF，但HFNO实施的简易性及其带来的呼吸舒适度绝不应降低对可能需要气管插管患者的临床监测，且不应过度延迟。
