Cánula nasal de alto flujo: Revisión Sistemática

High flow nasal cannula: Systematic Review

Autores/as

  • Ruth Ortiz Kinesiología y Fisioterapia, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, San Lorenzo – Paraguay

Resumen

 Introducción: Hay una creciente aplicación de la terapia con oxígeno de cánula nasal de alto flujo (HFNC) como primera línea o uso complementario durante la ventilación mecánica no invasiva para evitar la intubación endotraqueal y mejorar el resultado hospitalario corto. Algunas ventajas bien conocidas como las aplicaciones fáciles, la comodidad del paciente son determinantes clave que justifican la presente investigación. Metodología: Es un estudio de revisión sistemática de la literatura médica. Se realizó una búsqueda en línea de publicaciones relevantes en PubMed, CICCO y Web of Science. La búsqueda se restringió a artículos escritos en inglés o español. Resultados: Se evaluaron 692 textos completos se los cuales finalmente se seleccionaron 13, la principal causa de eliminación fue, que iban dirigidos a población pediátrica o que no indicaban de forma explícita el mecanismo de acción y las indicaciones clínicas del uso de la cánula de alto flujo. Conclusión: Se ha propuesto que la cánula de alto flujo puede proporcionar varios beneficios. Entre estos se encuentran el mantenimiento de una FiO2 constante, la generación de una presión positiva al final de la espiración (PEEP), la reducción del espacio muerto anatómico, la mejora del aclaramiento mucociliar y la reducción del trabajo de respiración.

 Palabras clave: cánula de alto flujo; kinesiología; fisioterapia.

ABSTRACT

Introduction: There is a growing application of high flow nasal cannula oxygen therapy (HFNC) as a first line or complementary use during non-invasive mechanical ventilation to avoid endotracheal intubation and improve the short hospital outcome. Some advantages well known as easy applications, patient comfort are key determinants that justify this research. Methodology: It is a systematic review study of the medical literature. An online search of relevant publications was conducted in PubMed, CICCO and Web of Science. The search was restricted to articles written in English or Spanish. Results: 692 full texts were evaluated, 13 of which were finally selected, the main cause of elimination was, that they were aimed at the pediatric population or that they did not explicitly indicate the mechanism of action and the clinical indications of the use of the cannula high flow Conclusion: It has been proposed that the high flow cannula can provide several benefits. Among these are the maintenance of a constant FiO2, the generation of a positive pressure at the end of expiration (PEEP), the reduction of anatomical dead space, the improvement of mucociliary clearance and the reduction of breathing work.

Keywords: high flow cannula; kinesiology; physiotherapy.

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Citas

1. Wettstein RB. A fresh look at the physiologic effects of high-flow nasal cannulae and the role they play in patient care. Respir Care. 2013;58(4):715–6. https://dx.doi.org/10.4187/respcare.02388
2. Roca O, Pérez-Terán P, Masclans JR, Pérez L, Galve E, Evangelista A, et al. Patients with New York Heart Association class III heart failure may benefit with high flow nasal cannula supportive therapy: high flow nasal cannula in heart failure. J Crit Care. 2013;28(5):741–6. https://dx.doi.org/10.1016/j.jcrc.2013.02.007
3. Ritchie JE, Williams AB, Gerard C, Hockey H. Evaluation of a humidified nasal high-flow oxygen system, using oxygraphy, capnography and measurement of upper airway pressures. Anaesth Intensive Care. 2011;39(6):1103–10. https://dx.doi.org/10.1177/0310057X1103900620
4. Peters SG, Holets SR, Gay PC. High-flow nasal cannula therapy in do-not-intubate patients with hypoxemic respiratory distress. Respir Care. 2013;58(4):597–600. https://dx.doi.org/10.4187/respcare.01887
5. Nilius G, Franke K-J, Domanski U, Rühle K-H, Kirkness JP, Schneider H. Effects of nasal insufflation on arterial gas exchange and breathing pattern in patients with chronic obstructive pulmonary disease and hypercapnic respiratory failure. Adv Exp Med Biol. 2013;755:27–34. https://dx.doi.org/10.1007/978-94-007-4546-9_4
6. Mosca F, Colnaghi M, Agosti M, Fumagalli M. High-flow nasal cannula: transient fashion or new method of non-invasive ventilatory assistance? J Matern-Fetal Neonatal Med Off J Eur Assoc Perinat Med Fed Asia Ocean Perinat Soc Int Soc Perinat Obstet. 2012;25 Suppl 4:68–9. https://dx.doi.org/10.3109/14767058.2012.715003
7. Manley BJ, Owen LS, Doyle LW, Andersen CC, Cartwright DW, Pritchard MA, et al. High-flow nasal cannulae in very preterm infants after extubation. N Engl J Med. 2013;369 (15):1425–33. https://dx.doi.org/10.1056/NEJMoa1300071
8. Haq I, Gopalakaje S, Fenton AC, McKean MC, J O’Brien C, Brodlie M. The evidence for high flow nasal cannula devices in infants. Paediatr Respir Rev. 2014;15(2):124–34. https://dx.doi.org/10.1016/j.prrv.2013.12.002
9. Gotera C, Díaz Lobato S, Pinto T, Winck JC. Clinical evidence on high flow oxygen therapy and active humidification in adults. Rev Port Pneumol. 2013;19(5):217–27. https://dx.doi.org/10.1016/j.rppneu.2013.03.005
10. Frizzola M, Miller TL, Rodriguez ME, Zhu Y, Rojas J, Hesek A, et al. High-flow nasal cannula: impact on oxygenation and ventilation in an acute lung injury model. Pediatr Pulmonol. 2011;46(1):67–74. https://dx.doi.org/10.1002/ppul.21326
11. Fernandez-Alvarez JR, Gandhi RS, Amess P, Mahoney L, Watkins R, Rabe H. Heated humidified high-flow nasal cannula versus low-flow nasal cannula as weaning mode from nasal CPAP in infants ?28 weeks of gestation. Eur J Pediatr. 2014;173(1):93–8. https://dx.doi.org/10.1007/s00431-013-2116-2
12. Esquinas AM, Nakagawa NK, Da Silva LFF. Comment on “humidification with high-flow nasal cannula and airway epithelial cells: caution, still learning from an extremely complex environment.” Pulm Med. 2012;2012:368713. https://dx.doi.org/10.1155/2012/368713
13. Esquinas AM, Martin C. High-flow nasal cannula oxygen therapy in the emergency department: welcome, but selection should be the first step. Respir Care. 2013;58(5):e66-67. https://dx.doi.org/10.4187/respcare.02286
14. Collins CL, Barfield C, Horne RSC, Davis PG. A comparison of nasal trauma in preterm infants extubated to either heated humidified high-flow nasal cannulae or nasal continuous positive airway pressure. Eur J Pediatr. 2014;173(2):181–6. https://dx.doi.org/10.1007/s00431-013-2139-8
15. Chang GY, Cox CA, Shaffer TH. Nasal cannula, CPAP, and high-flow nasal cannula: effect of flow on temperature, humidity, pressure, and resistance. Biomed Instrum Technol .2011;45(1):69–74. https://dx.doi.org/10.2345/0899-8205-45.1.69
16. Esquinas AM, Karim HMR, Soo Hoo GW. Insight to the growing utilizations of high flow nasal oxygen therapy over non-invasive ventilation in community teaching hospital: alternative or complementary? Hosp Pract. 2018;46(4):170–1. https://dx.doi.org/10.1080/21548331.2018.1510283
17. Hernández G, Roca O, Colinas L. High-flow nasal cannula support therapy: new insights and improving performance. Crit Care. 2017;21(1):62. https://dx.doi.org/10.1186/s13054-017-1640-2
18. Demelo-Rodríguez P, Olmedo Samperio M, Gaitán Tocora DG, Cano Ballesteros JC, Andueza Lillo JA. Oxigenoterapia de alto flujo con cánula nasal: estudio preliminar en pacientes hospitalizados. Arch Bronconeumol. 2015;51(12):657–9. https://dx.doi.org/10.1016/j.arbres.2015.03.015
19. Chanques G, Constantin J-M, Sauter M, Jung B, Sebbane M, Verzilli D, et al. Discomfort associated with underhumidified high-flow oxygen therapy in critically ill patients. Intensive Care Med. 2009;35(6):996–1003. https://dx.doi.org/10.1007/s00134-009-1456-x
20. Chanques G, Riboulet F, Molinari N, Carr J, Jung B, Prades A, et al. Comparison of three high flow oxygen therapy delivery devices: a clinical physiological cross-over study. Minerva Anestesiol. 2013;79(12):1344–55. URL.
21. Mündel T, Feng S, Tatkov S, Schneider H. Mechanisms of nasal high flow on ventilation during wakefulness and sleep. J Appl Physiol. 2013;114(8):1058–65. https://dx.doi.org/10.1152/japplphysiol.01308.2012
22. Parke RL, Eccleston ML, McGuinness SP. The effects of flow on airway pressure during nasal high-flow oxygen therapy. Respir Care. 2011;56(8):1151–5. https://dx.doi.org/10.4187/respcare.01106
23. Parke RL, McGuinness SP. Pressures delivered by nasal high flow oxygen during all phases of the respiratory cycle. Respir Care. 2013;58(10):1621–4. https://dx.doi.org/10.4187/respcare.02358
24. Groves N, Tobin A. High flow nasal oxygen generates positive airway pressure in adult volunteers. Aust Crit Care Off J Confed Aust Crit Care Nurses. 2007;20(4):126–31. https://dx.doi.org/10.1016/j.aucc.2007.08.001
25. O’Driscoll BR, Howard LS, Davison AG. BTS guideline for emergency oxygen use in adult patients. Thorax. 2008;63(Suppl 6):vi1–68. https://dx.doi.org/10.1136/thx.2008.102947
26. Lenglet H, Sztrymf B, Leroy C, Brun P, Dreyfuss D, Ricard J-D. Humidified High Flow Nasal Oxygen During Respiratory Failure in the Emergency Department: Feasibility and Efficacy. Respir Care. 2012;57(11):1873–8. https://dx.doi.org/10.4187/respcare.01575
27. Roca O, Riera J, Torres F, Masclans JR. High-Flow Oxygen Therapy in Acute Respiratory Failure. Respir Care. 2010;55(4):408–13. URL.
28. Sztrymf B, Messika J, Bertrand F, Hurel D, Leon R, Dreyfuss D, et al. Beneficial effects of humidified high flow nasal oxygen in critical care patients: a prospective pilot study. Intensive Care Med. 2011;37(11):1780–6. https://dx.doi.org/10.1007/s00134-011-2354-6
29. Sztrymf B, Messika J, Mayot T, Lenglet H, Dreyfuss D, Ricard J-D. Impact of high-flow nasal cannula oxygen therapy on intensive care unit patients with acute respiratory failure: a prospective observational study. J Crit Care. 2012;27(3):324.e9-13. https://dx.doi.org/10.1016/j.jcrc.2011.07.075
30. Parke RL, McGuinness SP, Eccleston ML. A Preliminary Randomized Controlled Trial to Assess Effectiveness of Nasal High-Flow Oxygen in Intensive Care Patients. Respir Care. 2011;56(3):265–70. https://dx.doi.org/10.4187/respcare.00801
31. Helviz Y, Einav S. A Systematic Review of the High-flow Nasal Cannula for Adult Patients. Crit Care. 2018;22(1):71. https://dx.doi.org/10.1186/s13054-018-1990-4
32. Zhang J, Lin L, Pan K, Zhou J, Huang X. High-flow nasal cannula therapy for adult patients. J Int Med Res. 2016;44(6):1200–11. https://dx.doi.org/10.1177/0300060516664621
33. Zhao H, Wang H, Sun F, Lyu S, An Y. High-flow nasal cannula oxygen therapy is superior to conventional oxygen therapy but not to noninvasive mechanical ventilation on intubation rate: a systematic review and meta-analysis. Crit Care Lond Engl. 2017;21(1):184. https://dx.doi.org/10.1186/s13054-017-1760-8

Publicado

2019-08-31

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