Impact of High-Flow Nasal Cannula Oxygen Therapy on the Pressure of the Airway System in Humans.

IF 2.4 4区医学 Q2 CRITICAL CARE MEDICINE

Respiratory care Pub Date : 2024-10-29 DOI:10.4187/respcare.12082

Darío S Villalba, Amelia Matesa, Sabrina Boni, Facundo J Gutiérrez, Roque Moracci, Gustavo A Plotnikow

{"title":"Impact of High-Flow Nasal Cannula Oxygen Therapy on the Pressure of the Airway System in Humans.","authors":"Darío S Villalba, Amelia Matesa, Sabrina Boni, Facundo J Gutiérrez, Roque Moracci, Gustavo A Plotnikow","doi":"10.4187/respcare.12082","DOIUrl":null,"url":null,"abstract":"Background: The understanding of how pharyngeal pressure is transmitted to the trachea with high-flow nasal cannula (HFNC) implementation and the behavior of tracheal pressure in the presence of mouth leaks remains limited. This study aimed to assess the impact of HFNC administration on tracheal pressure by comparing measurements taken with open and closed mouth with varying flows.Methods: A crossover study was conducted between March 2019 and June 2023. Subjects age > 18 years, with a tracheostomy and who were in the process of decannulation were included. Tracheal and pharyngeal pressures were measured by using specific devices, with different HFNC flows and mouth conditions.Results: Nine subjects were assessed: 77% women, with an average age of 60.5 years. Tracheal pressure was significantly higher than pharyngeal pressure only in baseline conditions (P = .03). With regard to the rest of the scenarios, there were no significant differences between both pressures. Tracheal pressure was higher than the baseline condition both with an open mouth and a closed mouth (P = .02). The tracheal pressure at 60 L/min with an open mouth was higher than at 40 L/min (P = .042). The median pharyngeal pressure with a closed mouth was higher than with an open mouth, both with 40 and 60 L/min of flow (P = .048 and P < .001, respectively). Pharyngeal pressure at 60 L/min with an open mouth was higher than both baseline condition and at 40 L/min (P = .002 and P = .043, respectively). However, pharyngeal pressure with the closed mouth was significantly higher than with the open mouth both with 40 and 60 L/min of flow (P = .031 and P = .02 respectively).Conclusions: The implementation of HFNC changes airway pressures with values that impact at a tracheal level as the flow used increases. Our data contribute to the difficult interpretation of the existing interrelation between the programmed flow and its effects on the respiratory system.","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiratory care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4187/respcare.12082","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The understanding of how pharyngeal pressure is transmitted to the trachea with high-flow nasal cannula (HFNC) implementation and the behavior of tracheal pressure in the presence of mouth leaks remains limited. This study aimed to assess the impact of HFNC administration on tracheal pressure by comparing measurements taken with open and closed mouth with varying flows.

Methods: A crossover study was conducted between March 2019 and June 2023. Subjects age > 18 years, with a tracheostomy and who were in the process of decannulation were included. Tracheal and pharyngeal pressures were measured by using specific devices, with different HFNC flows and mouth conditions.

Results: Nine subjects were assessed: 77% women, with an average age of 60.5 years. Tracheal pressure was significantly higher than pharyngeal pressure only in baseline conditions (P = .03). With regard to the rest of the scenarios, there were no significant differences between both pressures. Tracheal pressure was higher than the baseline condition both with an open mouth and a closed mouth (P = .02). The tracheal pressure at 60 L/min with an open mouth was higher than at 40 L/min (P = .042). The median pharyngeal pressure with a closed mouth was higher than with an open mouth, both with 40 and 60 L/min of flow (P = .048 and P < .001, respectively). Pharyngeal pressure at 60 L/min with an open mouth was higher than both baseline condition and at 40 L/min (P = .002 and P = .043, respectively). However, pharyngeal pressure with the closed mouth was significantly higher than with the open mouth both with 40 and 60 L/min of flow (P = .031 and P = .02 respectively).

Conclusions: The implementation of HFNC changes airway pressures with values that impact at a tracheal level as the flow used increases. Our data contribute to the difficult interpretation of the existing interrelation between the programmed flow and its effects on the respiratory system.

查看原文本刊更多论文

高流量鼻导管供氧疗法对人体气道系统压力的影响

背景：人们对使用高流量鼻插管（HFNC）时咽部压力如何传递到气管以及存在口腔渗漏时气管压力的行为的了解仍然有限。本研究旨在通过比较张口和闭口时不同流量下的测量值，评估使用高流量鼻导管对气管压力的影响：方法：2019 年 3 月至 2023 年 6 月期间进行了一项交叉研究。研究对象包括年龄大于 18 岁、接受过气管造口术且正在解除封管的受试者。在不同的 HFNC 流量和口腔条件下，使用特定设备测量气管和咽部压力：结果：共评估了九名受试者：结果：9 名受试者接受了评估：77% 为女性，平均年龄为 60.5 岁。只有在基线条件下，气管压力才明显高于咽部压力（P = .03）。在其他情况下，两种压力之间没有明显差异。张口和闭口时的气管压力均高于基线条件（P = .02）。张嘴 60 升/分钟时的气管压力高于 40 升/分钟时的气管压力（P = .042）。流量为 40 和 60 升/分钟时，闭口时的咽压中值均高于张口时（P = .048 和 P <.001）。张口时，60 升/分钟的咽压均高于基线状态和 40 升/分钟的咽压（P = .002 和 P = .043）。但是，闭口时的咽压明显高于张口时的咽压（流量分别为 40 和 60 L/min）（P = .031 和 P = .02）：结论：随着使用流量的增加，HFNC 的实施会改变气道压力，其值会影响气管水平。我们的数据有助于解释现有的程序流量及其对呼吸系统的影响之间的相互关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Respiratory care 医学-呼吸系统

CiteScore

4.70

自引率

16.00%

发文量

209

审稿时长

1 months

期刊介绍： RESPIRATORY CARE is the official monthly science journal of the American Association for Respiratory Care. It is indexed in PubMed and included in ISI''s Web of Science.