Division of Respiratory Care, Department of Cardiopulmonary Sciences, College of Health Sciences, Rush University, Chicago, Illinois.
Department of Clinical Nutrition, College of Health Sciences, Rush University, Chicago, Illinois.
Respir Care. 2023 Sep;68(9):1229-1236. doi: 10.4187/respcare.10469. Epub 2023 Apr 18.
High-flow nasal cannula (HFNC) oxygen therapy is used to deliver warm and humidified gases to patients in respiratory failure. A purported advantage of HFNC oxygen therapy is that it can allow for oral feeding while on the device, although few data support this practice. The purpose of this study was to identify practices and opinions with regard to feeding practices during HFNC oxygen therapy.
A survey related to the practice and opinions of feeding practices during HFNC oxygen therapy was developed and sent to respiratory therapists, speech-language pathologists, physicians, advanced practice providers, and registered dietitians.
Respondents included 307 professionals from 14 different countries. Most respondents worked in an academic/teaching hospital ( = 174 [56.7%]) with patients ages ≥ 18 years ( = 282 [91.9%]). Most respondents stated that their institution did not have a specific feeding protocol for HFNC oxygen therapy ( = 246 [80.4%]) and felt that patients could have an oral diet during HFNC oxygen therapy if not in imminent danger of being intubated ( = 264 [86.3%]). Fewer than half of the respondents felt that patients should have a bedside/clinical swallow examination before eating and/or drinking during HFNC oxygen therapy ( = 143 [46.7%]). By profession, most physicians/advanced practice providers ( = 67 [59.3%]), respiratory therapists ( = 37 [62.7%]) and half of the registered dietitians ( = 16 [50%]) felt that bedside/clinical swallow examinations were unnecessary before eating and/or drinking with HFNC, but speech-language pathologists were in favor ( = 77 [75.5%]).
Most facilities did not have a protocol to guide feeding practices when HFNC oxygen therapy is used. Most clinicians felt that an oral diet is safe for stable patients not in danger of being intubated. In general, speech-language pathologists felt that patients on HFNC oxygen therapy should undergo a bedside/clinical swallow examination before eating and/or drinking.
高流量经鼻导管（HFNC）氧疗用于为呼吸衰竭患者输送温暖和加湿的气体。HFNC 氧疗的一个据称的优势是它可以允许患者在使用设备时进行口服喂养，尽管很少有数据支持这种做法。本研究的目的是确定与 HFNC 氧疗期间喂养实践相关的做法和意见。
开发了一项与 HFNC 氧疗期间喂养实践相关的实践和意见的调查，并将其发送给呼吸治疗师、言语语言病理学家、医生、高级执业医师和注册营养师。
受访者包括来自 14 个不同国家的 307 名专业人员。大多数受访者在学术/教学医院工作（=174[56.7%]），患者年龄≥18 岁（=282[91.9%]）。大多数受访者表示，他们的机构没有针对 HFNC 氧疗的具体喂养方案（=246[80.4%]），并认为如果患者没有即将插管的危险，则可以在 HFNC 氧疗期间进行口服饮食（=264[86.3%]）。不到一半的受访者认为患者在 HFNC 氧疗期间进食和/或饮水前应进行床边/临床吞咽检查（=143[46.7%]）。按专业划分，大多数医生/高级执业医师（=67[59.3%]）、呼吸治疗师（=37[62.7%]）和一半的注册营养师（=16[50%]）认为在 HFNC 期间进食和/或饮水前无需进行床边/临床吞咽检查，但言语语言病理学家表示赞成（=77[75.5%]）。
大多数设施在使用 HFNC 氧疗时没有指导喂养实践的方案。大多数临床医生认为，对于没有插管危险的稳定患者，口服饮食是安全的。一般来说，言语语言病理学家认为，HFNC 氧疗患者在进食和/或饮水前应进行床边/临床吞咽检查。
