High-Flow Nasal Cannula: It’s Not Just a Bunch of Hot Air!

Not every patient experiencing a moderate level of hypoxemic respiratory failure does well on a high-flow nasal cannula. (Photo courtesy Hamilton Medical AG)When I first started as a hospital respiratory therapist, the nasal cannula was our go-to low-flow (LFNC) device, designed to deliver an FiO₂ of approximately 24 to 44% at flows of 1 to 6 liters per minute. When patients needed more oxygen, we would typically consider a face mask using a humidified large volume nebulizer to deliver 35-50%. A tandem setup could deliver upward of 80-90%. When more oxygen was necessary, we had the NRB (non-rebreather) mask.

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